Drugs of interest to pathologists
Drugs related to surgical pathology
Gemcitabine hydrochloride

Author: Him G. Kwee, M.D. (see Authors page)

Revised: 4 December 2017, last major update November 2011

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Gemcitabine hydrochloride [title]

Cite this page: Kwee, H.G. Gemcitabine hydrochloride. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/drugsgemcitabine.html. Accessed December 17th, 2017.
Definition / general
  • A nucleoside analogue metabolic inhibitor
Trade name
  • Gemzar®
Clinical information
  • Approved by US Food and Drug Administration for:
    • Advanced ovarian carcinoma that has relapsed at least 6 months after finishing a platinum based chemotherapy, in combination with carboplatin
    • First line treatment of locally advanced inoperable (stage IIIA or IIIB) or metastatic (stage IV) non small cell lung carcinoma, in combination with cisplatin
    • First line treatment of metastatic breast carcinoma after failure with an anthracycline containing adjuvant therapy, unless anthracyclines were clinically contraindicated, in combination with paclitaxel
    • First line treatment of locally advanced (unresectable stage II or III) or metastatic (stage IV) adenocarcinoma of the pancreas as a single agent; also indicated if patient was previously treated with 5-fluorouracil
    • Unresectable or metastatic chemotherapy naïve pancreatic adenocarcinoma in combination with erlotinib
    • Urinary bladder carcinoma, stage IV, in combination with cisplatin (National Cancer Institute - Cancer Drug Information, 10 October 2011)
    • Initially, Gemzar was produced by Eli Lilly and Company; on 5 August 2011 generic gemcitabine made by Hospira, Inc. and price has decreased
Pathophysiology
  • Gemcitabine is a nucleoside analogue that replaces cytidine during DNA replication, which arrests tumor growth, resulting in apoptosis
  • Another target is the enzyme RNR (ribonucleotide reductase); drug binds to the RNR active site and inactivates it irreversibly; if RNR is inhibited, cell cannot produce deoxyribonucleotides that are needed for cell replication and repair (Wikipedia: Gemcitabine [Accessed 1 December 2017])
  • For squamous cell carcinomas of the lung, cisplatin and gemcitabine showed better survival than cisplatin and pemetrexed (J Clin Oncol 2008;26:3543) - pemetrexed is now used only for non squamous non small cell lung carcinoma