Gemzar
How it works
Inhibits DNA synthesis by mimicking deoxyribose. Activates apoptosis in rapidly dividing cells. First-line backbone for mPDAC.
The patient tolerates weekly GnP well. Monitor for cumulative neuropathy and declining counts. Australian protocol: eviQ 1375.
Dosing
Typical doses
- 1000 mg/m² IV
Schedule
- D1/D8/D15 of 28-day cyclecycle_linked
Side Effects
- •Myelosuppression (neutrophils, platelets, RBC) — nadir D10–14
- •Nausea, vomiting, loss of appetite
- •Fatigue, malaise
- •Flu-like syndrome (myalgia, fever)
- •Rash, mild alopecia, nail changes
- Febrile neutropenia — fever + ANC <500 is oncologic emergency
- Hemolytic-uremic syndrome (rare, <1%)
- Hepatotoxicity, elevated transaminases
Monitoring
- FBC (CBC) before each dose; ANC <1000 → hold or delay
- LFTs (ALT, AST, ALP, bilirubin) — baseline and D22
- U&Es, creatinine