Gemcitabine: once-weekly schedule active and better tolerated than twice-weekly schedule.

Abstract

This paper reviews the toxicity profile of gemcitabine, a novel anticancer drug. Gemcitabine has been administered using two different treatment schedules: once weekly or twice weekly for 3 weeks followed by a week of rest (one cycle). It was well tolerated and alopecia was not a problem. Toxicity was greater in the twice-weekly schedule. Comparing the once-weekly with the twice-weekly schedule, WHO grade 3 or 4 thrombocytopenia was reported in 4.7 and 25.6% of patients, respectively. Other hematological toxicity was minimal. Transient WHO grade 3 or 4 elevations of ALT and AST occurred in 9.2 and 7.2% of patients, respectively, in the once-weekly schedule. For the twice-weekly schedule the corresponding percentages were 12.2 and 13.8%. Symptomatic toxicity was greater in patients who received twice-weekly gemcitabine. Nausea and vomiting was mild and generally well controlled without 5HT3 antagonists. However, there was a greater incidence of nausea and vomiting on the twice-weekly schedule. Flu-like symptoms were documented in 19.8% of patients receiving once-weekly and 63.3% of patients receiving twice-weekly gemcitabine. Peripheral edema, not related to cardiac, hepatic or renal failure, was seen more often in patients on twice-weekly treatment. As the efficacy of gemcitabine in non-small cell lung cancer was equivalent when using both regimens, the better tolerated and more easily administered once-weekly schedule is recommended.

• Authors: C Martin, B Lund, H Anderson, N Thatcher
• Journal: Anti-cancer drugs (Anticancer Drugs) Vol. 7 Issue 3 Pg. 351-7 (May 1996) ISSN: 0959-4973 [Print] England
• PMID: 8792011 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antimetabolites, Antineoplastic
• Deoxycytidine
• Gemcitabine

Topics

• Antimetabolites, Antineoplastic (administration & dosage, adverse effects)
• Carcinoma, Non-Small-Cell Lung (drug therapy)
• Chemical and Drug Induced Liver Injury
• Clinical Trials as Topic
• Deoxycytidine (administration & dosage, adverse effects, analogs & derivatives)
• Drug Administration Schedule
• Humans
• Kidney Diseases (chemically induced)
• Lung Neoplasms (drug therapy)
• Neoplasms (drug therapy)
• Thrombocytopenia (chemically induced)
• Gemcitabine