Gemcitabine in the treatment of ovarian cancer

Gemcitabine is a nucleoside antimetabolite with established activity agains t several solid tumors. The activity of the drug in patients with ovarian c ancer has been reviewed both in patients who have received single drug trea tment and in patients who have received combination chemotherapy. The respo nse rates, with single agent gemcitabine, range from 13 to 24% both in prev iously treated and untreated patients. Doublets consisting of gemcitabine-c isplatin or gemcitabine-paclitaxel, in previously treated patients, induced response in 53% and 40% of the patients, respectively. In three studies, f irst-line treatment with the combination of cisplatin and gemcitabine induc ed remission in 53% to 71% of the patients. The triplet, including gemcitab ine, paclitaxel, and cisplatin or carboplatin, has been examined in previou sly treated patients and a response rate of 100% was observed. In previousl y untreated patients the combination of gemcitabine, paclitaxel, and carbop latin has been preferred due to a more favorable toxicity profile. The acti vity of this combination, observed in 25 evaluable patients, was very high as all patients responded. Complete remission was observed in 60% of the pa tients and partial remission in 40%. Based on these promising data the trip let consisting of gemcitabine, paclitaxel, and carboplatin has been include d in randomized trials both in the US and in Europe.