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Gemzar And Cisplatin

gemzar and cisplatin

Description

Combinations of gemcitabine (Gemzar) with cisplatin (Platinol) are among the most active new chemotherapy regimens developed for advanced non-small-cell lung cancer. Carboplatin (Paraplatin) is a platinum analog devoid of many of the nonhematologic toxicities associated with cisplatin. Although few direct comparisons have been made, when administered by area under the concentration-time curve (AUC) dosing, carboplatin is probably equivalent to cisplatin in advanced non-small-cell lung cancer and provides an improved therapeutic index. Based on its favorable toxicity profile, carboplatin has supplanted cisplatin for use in combination with paclitaxel in several different tumor types. Initial trials combining gemcitabine and carboplatin using standard days 1, 8, and 15 dosing of gemcitabine suggested that thrombocytopenia was problematic.

How Gemcitabine Works

Cancerous tumors are characterized by cell division, which is no longer controlled as it is in normal tissue.   "Normal" cells stop dividing when they come into contact with like cells, a mechanism known as contact inhibition.  Cancerous cells lose this ability.  Cancer cells no longer have the normal checks and balances in place that control and limit cell division.  The process of cell division, whether normal or cancerous cells, is through the cell cycle.  The cell cycle goes from the resting phase, through active growing phases, and then to mitosis (division).

Gemcitabine and Cisplatin

The most common dose and schedule has been gemcitabine delivered on days 1, 8, and 15, with cisplatin given on either days 1, 2, or 15 of a28-day schedule. In a recent phase III trial by Sandler et al,[4] this 28-dayschedule of gemcitabine (1,000 mg/m2 on days 1, 8, and 15) plus cisplatin (100mg/m2 on day) was compared to cisplatin alone in patients with advanced non-small-celllung cancer. Both response rate (30% vs 11%) and median survival (9 vs 6months) were increased in the combination arm. As in most studies using this28-day schedule, thrombocytopenia was dose-limiting, commonly resulting inomission of the day 15 gemcitabine dose

1). Grade 4 thrombocytopenia

occurred in 28% of patients receiving the combination; 22% received platelettransfusions. Similarly, in the phase III trial of Crino et al,[5] in whichgemcitabine was delivered on days 1, 8, and 15, and cisplatin was given on day2, grade 4 thrombocytopenia was reported in 38% of patients, while 15% received platelet transfusions.How Cisplatin + Gemzar chemotherapy is given and possible side effects.Cisplatin + Gemzar for the treatment of Non-Small Cell Lung CancerCisplatin + Gemzar (gemcitabine) is used in the treatment of non-small cell lung cancer.

  • Risk of Infection
  • Anemia
  • Bleeding
  • Nausea & Vomiting

Precaution

Before starting Gemcitabine treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).  Do not take aspirin or products containing aspirin unless your doctor specifically permits this.Do not receive any kind of vaccination without your doctor's approval while taking Gemcitabine.Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (Gemcitabine may be hazardous to the fetus.  Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus).For both men and women: Do not conceive a child (get pregnant) while taking Gemcitabine. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.Do not breast feed while taking Gemcitabine.

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