Gemcitabine combination chemotherapy of ovarian cancer.
OBJECTIVE
Used alone, gemcitabine has shown modest, albeit significant, activity in patients with ovarian cancer. The response rate is usually greater when it is used in combination with other agents, and many combinations of gemcitabine show promise. This review summarizes the results of clinical trials where gemcitabine has been used in combination with other cytotoxic agents for the treatment of ovarian cancer in both newly diagnosed patients and those whose disease recurred despite heavy prior treatment.


METHODS
The results of several clinical trials in which gemcitabine was used in combination with platinum compounds, paclitaxel, or other chemotherapeutic agents as either first-line or salvage therapy of ovarian cancer were reviewed.


RESULTS
Gemcitabine appears to act synergistically when combined with a platinum compound, producing response rates as high as 71% in previously untreated patients. The addition of paclitaxel to this combination was even more effective for first-line therapy. When used in the salvage setting, combinations of gemcitabine with cisplatin or carboplatin and/or other cytotoxic agents were also effective and well tolerated.


CONCLUSIONS
Combinations of gemcitabine with platinum compounds and/or other chemotherapeutic agents have significant activity with acceptable toxicity in patients with ovarian cancer, whether used as first-line therapy or in the salvage setting. The exact dosing and different mechanism of action of gemcitabine make it attractive for these combinations.
Mutch
David G
DG
Department of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO 63110, USA. mutchd@msnotes.wustl.edu
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D002986:Clinical Trials as Topic; D003841:Deoxycytidine / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D004357:Drug Synergism; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D016879:Salvage Therapy; D000093542:Gemcitabine
D003841:Deoxycytidine; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D000093542:Gemcitabine