Gemcitabine (Gemzar(上標 ®)2',2'-inuoredeoxycytidine),乃一種pyrimidine類抗代謝藥,結構與deoxycytidine結構相似,只有在2-碳上的「氫」被兩個「氟」所取代,是新一代的抗癌藥物,目前主要在治療胰臓癌、乳癌、膀胱癌、血癌和肺癌。其作用包括阻止DNA的延長(elongation),抑制DNA修補酵素和RNA合成酵素,因此可阻止DNA的複製和修補。由於與paclitaxel和carboplatin無相互的拮抗,因此可共同使用,以加強殺死癌細胞之功用。在晚期卵巢癌,paclitaxel和carboplatin初期治療這效果不錯,緩解率達到60-80%,但復發機會高,最後>70%病患死於癌病,如果有新的藥物,能在開始時加入第一線治療,可能會增加痊癒的機會,或可作為復發後的救援藥物。本文乃回顧gemcitabine在婦癌上發表過的文章供同仁參考。
Ovarian cancer remains the leading cause of gynecologic cancer death. Although ovarian cancer is very responsie to chemotherapy, most of patients who present with advanced disease ultimately die of the disease. Gemcitabine is a deoxycytidine analog antimetabolite, it has antitumor activity in heavily pretreated patient with recurrent ovarian cancer. In addition, the combination of gemcitabine, carboplatin and paclitaxel is active and feasible in previously untreated and treated patients with ovarian cancer. The treatment of gemcitabine in other gynecologic cancers is warrant in more studies.