Gemcitabine. New first-line therapy for pancreatic cancer.

Gemcitabine hydrochloride, a pyrimidine antimetabolite, recently was approved as first-line therapy for patients with locally advanced or metastatic adenocarcinoma of the pancreas. This agent also is indicated for use by patients previously treated with 5-FU. Using a new system to measure improvement in disease-related symptoms, two key clinical trials have demonstrated significant clinical benefit responses and a favorable adverse effect profile in patients receiving gemcitabine. With additional experience, the role of gemcitabine in pancreatic cancer, alone or in combination with other antineoplastic agents, will be defined further. The activity of gemicitabine against other malignancies such as ovarian, breast, bladder, small-cell and non-small-cell lung cancers also is being investigated actively.