Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Gemzar (Eli Lilly Australia)
200 mg in 10 mL vials and 1 g in 50 mL vials
Indication: non-small cell lung cancer
Unresectable non-small cell lung cancer has been treated with radiotherapy, but there may also be a role for gemcitabine. Gemcitabine is an analogue of cytarabine. It kills cells by inhibiting DNA synthesis, so it also causes bone marrow suppression.
The drug is given weekly, by intravenous infusion, for 3 weeks. There is a one-week rest period and then the cycle is repeated. The dose is adjusted according to the effect on white blood cells and platelets. Intracellular metabolism produces active nucleosides. While these intracellular metabolites are not found in the urine, only 10% of the drug is excreted unchanged. The main metabolite found in the urine is inactive.
Patients with unresectable non-small cell lung cancer have a poor prognosis. Although approximately 20% of patients will respond to gemcitabine, a beneficial effect on survival has not been shown.
Many patients will experience adverse reactions. In addition to leucopenia, thrombocytopenia and anaemia, gemcitabine can cause rashes, oedema, haematuria, flu-like symptoms, nausea and vomiting.