Beyond pancreatic cancer: Irinotecan and gemcitabine in solid tumors and hematologic malignancies

Abstract

Non-platinum combinations including gemcitabine and irinotecan (Gemzar; Eli Lilly and Company, Indianapolis, IN) for the management of a variety of malignancies have started to emerge. Gemcitabine and irinotecan are well-tolerated single agents, each with a broad spectrum of antitumor activity. Preclinical data suggests synergy for the two drugs when used in combination. A phase I trial has defined a well-tolerated combination regimen using both drugs on a day-1, -8 schedule every 3 weeks. Phase II data suggest activity for the combination in pancreatic cancer, and a phase III trial of the two-drug combination versus gemcitabine alone is underway in previously untreated pancreatic cancer patients. Other phase II trials evaluating the impact of this combination on a variety of other tumors, such as non-small cell lung, small cell lung, breast, colorectal, and non-Hodgkin's lymphoma, are either forthcoming or in progress. Semin Oncol 28 (suppl 10):34-43.

Should patients with locally advanced, non-metastatic carcinoma of the pancreas be irradiated?

“…Novel active substances, e.g. gemcitabine or paclitaxel, have been identified and the mode of application of 5-FU was optimized using continuous infusion [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The question arose whether radiotherapy was still a necessity in locally advanced pancreatic cancer.…”

Triplex-forming oligonucleotides targeting c-MYC potentiate the anti-tumor activity of gemcitabine in a mouse model of human cancer

“…The triphosphate, once incorporated into DNA, is a potent inhibitor of DNA synthesis and induces apoptosis [3,24]. GEM has significant activity against a broad spectrum of tumors when used as a single agent and can show synergistic antitumor activity in combination with DNA-damaging agents [25][26][27][28].…”