Drugs of interest to pathologists - Gemcitabine hydrochloride

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Drugs of interest to pathologists

Drugs related to surgical pathology

Gemcitabine hydrochloride

Author: Him G. Kwee, M.D. (see Reviewers/Authors page)
Revised: 29 November 2011, last major update November 2011
Copyright: (c) 2011, PathologyOutlines.com, Inc.

General
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● A nucleoside analogue metabolic inhibitor

Trade name
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● Gemzar

Clinical information
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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, October 10, 2011)

● Initially, Gemzar was produced by Eli Lilly and Company; on 5 August 2011 generic gemcitabine made by Hospira, Inc., and price has deceased

Pathophysiology
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● 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)
● 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

End of Drugs > Drugs related to surgical pathology > Gemcitabine hydrochloride

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