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Related Experiment Videos

Gemcitabine-cisplatin: a schedule finding study.

J R Kroep1, G J Peters, C J van Moorsel

  • 1Department of Medical Oncology, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|January 22, 2000
PubMed
Summary
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The sequence of gemcitabine before cisplatin reduced leukopenia toxicity in advanced solid tumors. This finding guides optimal chemotherapy scheduling for improved patient outcomes.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Cisplatin and gemcitabine are standard chemotherapy agents.
  • Optimizing administration schedules can improve tolerability and efficacy.
  • Evaluating alternating schedules is crucial for advanced solid tumors.

Purpose of the Study:

  • To assess the tolerability of four alternating cisplatin-gemcitabine schedules.
  • To evaluate the clinical efficacy of this combination therapy.
  • To identify the optimal sequence for reduced toxicity.

Main Methods:

  • Forty-one patients with advanced solid tumors received alternating cisplatin-gemcitabine.
  • Four schedules were evaluated: gemcitabine preceding cisplatin by 4 or 24 hours, and vice versa.

Related Experiment Videos

  • Toxicity and clinical response were assessed for each schedule.

    • Main Results:

    • Myelosuppression was the primary toxicity, particularly grade 3/4 thrombocytopenia (66%) and leukopenia (46%).
    • Leukopenia was significantly less toxic when gemcitabine preceded cisplatin by 24 hours (P=0.003).
    • Non-hematological toxicity was moderate; objective responses were observed in 9/36 patients.

    Conclusions:

    • Gemcitabine administered 24 hours before cisplatin demonstrated reduced leukopenia toxicity.
    • This sequence was selected for further Phase II evaluation.
    • Encouraging responses were noted in specific cancer types, including esophageal cancer.