Gemcitabine in combination with new platinum compounds: An update

Combinations of gemcitabine (Gemzar) with cisplatin (Platinol) are among th e most active new chemotherapy regimens developed for advanced non-small-ce ll lung cancer. Carboplatin (Paraplatin) is a platinum analog devoid of man y of the nonhematologic toxicities associated with cisplatin. Although few direct comparisons have been made, when administered by area under the conc entration-time curve (AUC) dosing, carboplatin is probably equivalent to ci splatin in advanced non-small-cell lung cancer and provides an improved the rapeutic index. Based on its favorable toxicity profile, carboplatin has su pplanted cisplatin for use in combination with paclitaxel in several differ ent tumor types. Initial trials combining gemcitabine and carboplatin using standard days 1, 8, and 15 dosing of gemcitabine suggested that thrombocyt openia was problematic. More recently, 21-day schedules in which gemcitabin e is administered only on days I and 8 have demonstrated both efficacy and improved toxicity profiles. Here we review recent studies investigating gem citabine plus carboplatin and preliminary data regarding combinations of ge mcitabine with the new platinum analog oxaliplatin.