<p>Prolonged low-dose infusion for gemcitabine: a systematic review</p>

Abstract

Background The present standard dose of gemcitabine (Gem), a pyrimidine antimetabolite, is 1,000–1,250 mg/m 2 , and the infusion time is 30 min. However, pharmacological studies have demonstrated that Gem with prolonged infusion could attain a better accumulation rate of Gem triphosphate (active metabolites of Gem), indicating that Gem with prolonged infusion is superior to 30-min infusion. Thus, this systematic review aims to provide some references for Gem administered as a prolonged infusion. Methods We searched electronic databases, including PubMed, EMBASE, Cochrane Library, and CNKI, for trials. Keywords were “Gem,” “prolonged infusion,” and “low-dose.” In addition, we used the Cochrane Handbook V5.1.0 and methodological index for non-randomized studies to evaluate the quality of randomized controlled trials (RCTs) and non-RCTs, respectively. Furthermore, Cochrane Collaboration guidelines and the PRISMA statement were adopted. Results We systematically reviewed 19 studies (5 RCTs and 14 non-RCTs). All studies assessed the efficacy and safety of Gem administered as a prolonged low-dose infusion (P-LDI) and reported that Gem administered as P-LDI was effective and well tolerated. Conclusion Gem administered as P-LDI is effective, safe, and economical, especially suited for patients with poor performance status or without good economic condition.

Combination of Low-Dose Gemcitabine and PD-1 Inhibitors for Treatment in Patients With Advanced Malignancies

“…Additionally, low-dose gemcitabine selectively inhibits tumor-associated myeloid-derived suppressor cells in mice bearing 4T1 mammary carcinomas, which is beneficial to the amplification of tumor-targeting T cells ( 20 ). Moreover, a systematic review revealed that, compared with standard-dose infusion for gemcitabine, prolonged low-dose infusion is an effective and well-tolerated regimen for multiple solid tumors ( 21 ).…”