Gemcitabine is a nucleoside analog used as chemotherapy. It is marketed as Gemzar® by Eli Lilly and Company.
Chemically gemcitabine is a nucleoside analog in which the hydrogens on the 2' carbons of deoxycytidine are replaced by fluorines.
As with fluorouracil and other analogues of pyrimidines, the drug replaces one of the building blocks of nucleic acids, in this case cytidine, during DNA replication. The process arrests tumor growth, as new nucleosides cannot be attached to the "faulty" nucleoside, resulting in apoptosis (cellular "suicide").
Gemcitabine is used in various carcinomas: non-small cell lung cancer, pancreatic cancer, bladder cancer and breast cancer. It is being investigated for use in oesophageal cancer, and is used experimentally in lymphomas and various other tumor types. Gemcitabine represents an advance in pancreatic cancer care. It is also not as debilitating as other forms of chemotherapy.
"Adjuvant Chemotherapy With Gemcitabine vs Observation in Patients Undergoing Curative-Intent Resection of Pancreatic Cancer: A Randomized Controlled Trial" reported in the Journal of the American Medical Association (JAMA. 2007;297:239.) suggest that gemcitabine shows benefit in patients with pancreatic cancer who were felt to have successful tumor resections.
Gemcitabine became first line treatment for bladder cancer Stage 4 with metastases in combination with Cisplatin after a study with 405 patients showed similar efficacy but less toxicity compared to the former MVAC regimen ( J Clin Oncol 2000;18:3068). This new CG-regimen is Cisplatin on day 2, Gemcitabine on days 1,8,15