OpenOnco
UA EN
Plan Builder Onco Wiki Tumor Board

Onco Wiki / Drug

Gemcitabine

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDDRUG-GEMCITABINE
TypeDrug
Aliases
2',2'-difluorodeoxycytidineGemzarInfugemdFdCГемцитабін
Statusreviewed 2026-04-26 | pending_clinical_signoff
DiseasesDIS-BREAST DIS-CHOLANGIOCARCINOMA DIS-NK-T-NASAL DIS-OVARIAN DIS-PDAC DIS-SOFT-TISSUE-SARCOMA DIS-UROTHELIAL
SourcesSRC-ESMO-PANCREATIC-2024 SRC-NCCN-PANCREATIC-2025

Drug Facts

ClassAntimetabolite (deoxycytidine analog)
MechanismPyrimidine nucleoside analog of deoxycytidine. Phosphorylated by deoxycytidine kinase (rate-limiting) to active metabolites gemcitabine diphosphate (dFdCDP) and triphosphate (dFdCTP). dFdCDP inhibits ribonucleotide reductase, depleting deoxynucleotide pools required for DNA synthesis (self-potentiation effect — increases cellular dFdCTP). dFdCTP is incorporated into DNA, after which one additional natural nucleotide is added before DNA polymerase stalls — "masked chain termination" — making the lesion resistant to exonucleolytic repair. Cell cycle phase-specific (S phase) with G1/S blockade. PDAC backbone (gem-nab-pac MPACT, gem mono in frail), biliary tract cancers, NSCLC, bladder, NK/T-nasal lymphoma (SMILE), Hodgkin / DLBCL salvage (GDP).
Typical dosingPDAC gem-nab-pac (MPACT): 1000 mg/m² IV over 30 min days 1, 8, 15 of 28-day cycle. PDAC mono (frail): 1000 mg/m² IV over 30 min weekly × 7, then rest 1 week, then 3-of-4-weekly thereafter. Adjuvant PDAC mono: 1000 mg/m² IV weekly × 3 of every 4 weeks × 6 cycles. Adjuvant biliary tract (BILCAP): 1000 mg/m² IV weekly × 3 of 4 × 8 cycles, with capecitabine. NSCLC (with cisplatin): 1000-1250 mg/m² IV days 1, 8 q21d. Bladder (gem-cis): 1000 mg/m² IV days 1, 8, 15 q28d with cisplatin. Ovarian (with carboplatin): 1000 mg/m² IV days 1, 8 q21d. GDP (lymphoma salvage): 1000 mg/m² IV days 1, 8 q21d. SMILE (NK/T): 1000 mg/m² IV day 1, 8 of 28-day cycle (with steroids, MTX, ifosfamide, L-asparaginase, e...
Ukraine registeredTrue
NSZU reimbursedTrue
Ukraine last verified2026-04-27

Warnings

Notes

Day-15 dose often held for ANC <1.5 or platelets <100. HUS / TMA rare but catastrophic — monitor renal function + hemolysis labs (LDH, haptoglobin, schistocytes) periodically; discontinue permanently if confirmed. Pulmonary toxicity (cough, dyspnea, new hypoxia) requires immediate workup including CT and discontinuation. Already used in NK/T SMILE — reuse this entity rather than duplicate. Radiation recall: severe mucocutaneous reactions in prior RT field — increase awareness when sequencing or combining with RT (esp. esophageal, lung, pelvic). For PDAC: gem-nab-pac modestly outperforms gem mono (MPACT mOS 8.5 vs 6.7); FOLFIRINOX preferred in fit ECOG 0; gem mono for frail.

Used By

Regimens