There have been exciting new developments in anticancer therapy over the pa
st few years. One such therapy uses gemcitabine (GemzarR), an antimetabolit
e approved in 1996 by the Food and Drug Administration (FDA) for first-line
treatment of locally advanced (nonresectable stage II or stage III) or met
astatic (stage N) adenocarcinoma of the pancreas. This novel nucleoside ana
log resembles the naturally occurring pyrimidine nucleoside deoxycytidine,
but it has a unique mechanism of action. Clinical studies with gemcitabine
have demonstrated anticancer activity in pancreatic cancer; non-small-cell
lung cancer; breast, bladder, and ovarian cancers; and small-cell lung canc
er. Clinical trials in patients with cancer of the pancreas used a novel st
udy endpoint called clinical benefit response (CBR) to measure gemcitabine'
s effect on disease-related symptoms. The CBR is a composite assessment of
performance status, pain, and weight gain. Studies show that gemcitabine ha
s a relatively mild safety profile, with myelosuppression as the major dose
-limiting toxicity. The aim of this review is to provide the oncology nurse
with an overview of gemcitabine's pharmacology, innovative clinical trial
end points, and clinical performance, as well as the nursing care required
for the patient receiving this drug.