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Expert Opin Drug Metab Toxicol. 2011 Dec;7(12):1601-12. doi: 10.1517/17425255.2011.625012. Epub 2011 Sep 28.

Pharmacokinetic evaluation of gemcitabine hydrochloride for the treatment of cervical cancer.

Author information

  • 1Instituto de Investigaciones Biomedicas Unam/Instituto Nacional de Cancerología, Mexico. alfonso_duenasg@yahoo.com

Abstract

INTRODUCTION:

Cervical cancer is the third most prevalent cancer in females worldwide. When advanced, the disease requires primary radiation concurrent with chemotherapy. However, chemotherapy alone is the standard treatment for recurrent/persistent/metastatic disease.

AREAS COVERED:

Areas covered in this review include the treatment of advanced cervical cancer with gemcitabine as radiosensitizer, either alone or in combination with cisplatin. The use of gemcitabine for recurrent/persistent/metastatic cervical cancer is also reviewed.

EXPERT OPINION:

Statistically significantly better survival rates are achieved with cisplatin doublets against cisplatin alone, in the management of recurrent/persistent/metastatic cervical cancer. The choice of the cisplatin doublet with paclitaxel, vinorelbine, gemcitabine and topotecan arms should be based on physician preference, pre-existing morbidity and patient-related factors. In advanced disease, a recently reported Phase III trial establishes the novel regimen of concurrent gemcitabine plus cisplatin and external radiation, followed by brachytherapy and two adjuvant 21-day cycles of gemcitabine plus cisplatin, as significantly improving survival outcomes when compared with the current standard of care. The increased acute toxicity of this regimen is clear; however, this should not deter its incorporation into clinical practice, in that the toxicity is predictable and manageable; nevertheless, the occurrence of late toxicity and survival at longer follow-up time are reasonable concerns in this regimen.

PMID:
21955161
[PubMed - indexed for MEDLINE]
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