What Is Gemcitabine?
Gemcitabine—also known by its brand name, Gemzar—is a chemotherapy drug doctors classify as an antimetabolite, a group of drugs that slows the growth of mesothelioma by interfering with the replication of cancer cells and tumor expansion.
Tumors form when normal cells become cancerous, and start growing out of control. Normally, a healthy cell will divide a certain number of times, then undergo apoptosis, pre-programmed cell death. Cancer cells bypass apoptosis, and continue to replicate until they form a tumor.
Gemcitabine stops the replication of renegade cancer cells by interfering with their production of DNA and RNA, the building blocks of new cells. Lacking DNA and RNA, a cancer cell can’t create new cells, and undergoes apoptosis.
Researchers have shown how effective gemcitabine can be as a mesothelioma treatment—especially when it’s paired with other chemotherapy drugs. In a recent study, they reported that the combination of gemcitabine and carboplatin resulted in 50 percent of the patients surviving 1 year, 30 percent surviving 2 years and 20 percent surviving 3 years. Given the average life expectancy of a mesothelioma patent is 1 year, these results are incredibly promising for the future of mesothelioma treatment.
Researchers have also shown that gemcitabine is an effective second-line treatment, which doctors use for patients whose mesothelioma didn’t respond to initial, first-line treatment. In a 2014 study, they reported positive results: patients treated with second-line gemcitabine experienced a median survival rate of 5 months—in addition to the benefits they received from their initial treatment.
Gemcitabine in Clinical Trials
Because it works so well with other drugs, researchers frequently test gemcitabine in clinical trials. They pair it with different drugs to find the best combination for improving the prognosis of mesothelioma patients.
Gemcitabine and Docetaxel: In a recent Phase 2 clinical trial, researchers combined gemcitabine and docetaxel, an antimitotic drug, with promising results. They produced an average survival rate of 16 months in patients who did not previously respond to chemotherapy. In the future, researchers may develop the combination into an effective second-line treatment.
Gemcitabine and Alimta (pemetrexed): In a recent 2014 study, researchers used gemcitabine works as a second-line treatment after Alimta, the most successful chemotherapy drug used to treat mesothelioma. Patients who received this combination showed an overall survival rate of approximately 21 months, versus the 13 months survival rate produced by Alimta alone.
Gemicitabine as a third-line treatment: A study published in 2015 showed the potential gemcitabine holds as a third-line treatment, which is rare for mesothelioma. Researchers gave patients a combination of gemcitabine, carboplatin, and doxorubicin after two previous treatments of various chemotherapy drugs. The combination extended patient survival time by 6.8 months, with a disease control rate of 60 percent.
How Doctors Give It
Doctors give gemcitabine to patients via IV, over the course of 30 minutes, once a week. The exact dosage and number of treatment cycles depends on the patient’s height, weight, overall health and location of mesothelioma.
Like most chemotherapy drugs, gemcitabine cannot differentiate between healthy cells and cancer cells. It sometimes interferes in the replication process of normal, non-cancerous cells, and causes apoptosis, or cell death. When healthy cells die, side effects occur. Fortunately, side effects are temporary; they fade away once a patient complete chemotherapy.
Side effects commonly caused by gemcitabine include:
- Flu-like symptoms
- Weakened immune system (caused by lowered white blood cell count)
- Anemia (caused by lowered red blood cell count)
- Hair loss
- Soreness (in muscles and joints)
Gemcitabine also causes mild changes in how kidneys work. For this reason, doctors don’t give it to patients with abnormally functioning kidneys. They’ll usually run a blood test before administering the chemotherapy to determine if gemcitabine will have a negative effect on their patient.
Is it Right for You?
Only an experienced doctor who’s treated mesothelioma can determine if gemcitabine, or any other treatment, is right for you. A good doctor will review your diagnosis and treatment history, and decide if gemcitabine can improve your prognosis.