Gemcitabine and cisplatin (GC) | Cancer information (2023)

GC is the name of a chemotherapy combination that includes:

  • gemcitabine
  • cisplatin

It is a treatment for a number of different types of cancer.

How GC works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have GC

You have these drugsinto your bloodstream (intravenously).

You might have treatment through a long plastic tubethat goesinto a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

  • central line
  • PICC line
  • portacath

If you don't have a central line

You mighthave treatmentthrough a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

When you have GC

You usually have GC chemotherapy as cycles of treatment. Each cycle takes 3 weeks.

You usually have between 4 to 6 cycles of treatment taking from 3 to 6 months.

Day 1

  • You have gemcitabine as a drip into your bloodstream over 30 minutes.
  • You have cisplatin as a drip into your bloodstream over 1 to 4 hours.

Day 2 to 7

  • You have no treatment.

Day 8

(Video) Dr. Gupta on the Use of Enzalutamide, Gemcitabine, and Cisplatin in Metastatic Bladder Cancer

  • You have gemcitabine as a drip into your bloodstream over 30 minutes.

Day 8 - bladder and bile duct cancer only

  • You have cisplatin as a drip into your bloodstream over 30 minutes.

You then start a new cycle of treatment.

Tests

You have blood tests before and during yourtreatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

How often and how severe the side effects are can vary from person to person. They also depend on what othertreatments you're having. For example, your side effects could be worse if you're also having other drugsor radiotherapy.

When to contact your team

Your doctor,nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better.

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Increased risk of infection

Increased risk of getting an infectionis due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

(Video) Cisplatin explained | Anticancer medicine | How does Cisplatin work? | Concept-1

Infections can sometimes be life threatening. You should contact youradvice line urgently if you think you have an infection.

Bruising, bleeding gums or nose bleeds

This is due to a drop in thenumber ofplatelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Breathlessness and looking pale

You might be breathlessand lookpale due to a drop in red blood cells. This is calledanaemia.

Changes to your hearing

You might have some hearing loss, especially with high pitched sounds. You might also have some ringing in your ears (tinnitus).Tell your doctor or nurse if you notice any changes.

Low levels of sodium in your blood

Sodium is a salt, and having these drugs can lower its levels in your blood. The symptoms of low sodium include headache, feeling and being sick, confusion, and restlessness. The levels usually go back to normal when you finish treatment. You have regular blood tests to check this.

Feeling or being sick

Feeling or being sickis usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniquescan allhelp.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.

Liver changes

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatmentfinishes. You have regular blood tests to check for any changes in the way your liver is working.

Skin problems

Skinproblemsincludea skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your nurse willtell you what products you can use on your skin to help.

Hair thinning and hair loss

You may have some hair loss or hair thinning. This can be upsetting. Your hair might grow back once treatment has finished.

Blood and protein in your urine

Small amounts of blood and protein in your urine may be found when your nurse tests your urine. This usually goes away on its own. If there are large amounts of protein you may have tests to check how well your kidneys are working.

Flu-like symptoms

You may have headaches, muscle aches (myalgia), a high temperature and shivering.You should contact your advice line urgently if you have these symptoms.

Taste changes

Taste changesmay make you go off certain foods and drinks. You may also find that some foods taste different from usual or that you prefer to eat spicier foods.Your taste gradually returns to normal a few weeks afteryour treatment finishes.

Swelling of the face, hand, feet (oedema)

You may have swelling of your face, hands and feetdue to a build up of fluid (oedema).

(Video) Gemcitabine || What Are The Side Effects?? || Everything You Need To know || Dr. Bharat Patodiya

High temperature (fever)

If you get a high temperature, let your health care teamknow straight away. Ask them if you can take paracetamol to help loweryour temperature.

Kidney changes

You might have some changes inthe way your kidneys work. You have regular blood tests to check how well they are working.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

  • blood clots that are life threatening; signs are pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms
  • heart problems such as slow, fast or irregular heartbeat – rarely this can cause a heart attack
  • a loss of appetite (anorexia)
  • a sore mouth and ulcers
  • headaches
  • drowsiness or problems with sleeping (insomnia)
  • inflammation of the lining of the nose (rhinitis), symptoms might include a runny nose, cough and sneezing
  • coughing
  • diarrhoea or constipation
  • high levels of bilirubin in your blood – you have regular blood tests to check this
  • sweating
  • back or muscle pain
  • tiredness and weakness
  • a serious reaction to an infection (sepsis) signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering - contact your advice line straight away if you have any of these symptoms
  • shivering and shaking (chills)
  • numbness or tingling in the hands and feet

Rare side effects

This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

  • an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness - some allergic reactions can be life-threatening alert your nurse or doctor if notice any of these symptoms
  • skin rash on areas previously exposed to radiotherapy
  • changes in the lungs such as scarring of the air sacs of the lung (interstitial pneumonitis) and wheeze
  • a condition that causes blood clots to form in the small blood vessels in the kidneys (haemolytic uraemic syndrome), this leads to low red blood cells (anaemia), kidney failure and low levels of platelets
  • a second cancer called acute leukaemia
  • low levels of magnesium in your blood. You have regular tests to check this
  • changes in the brain that are usually reversible, causing a sudden onset of symptoms including headaches, dizziness, confusion, fits (seizures) and changes to vision (reversible posterior leukoencephalopathy syndrome)
  • seizures (fits)
  • leaking of fluid and proteins out of the blood vessels into the tissues (capillary leak syndrome)

Other side effects

For more information about the side effects of individual drugs:

  • gemcitabine
  • cisplatin

Coping with side effects

We have more information about side effects and tips on how to cope with them.

  • Read more about how to cope with side effects

What else do I need to know?

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Alcohol

Some brands of gemcitabine contain alcohol (equal to half a glass of wine or half a pint of beer) and may make you drowsy or dizzy, especially if you have drunk alcohol. Don't operate machinery or drive if you feel drowsy.

Sodium

Cisplatin contains sodium (salt). You mightneed to keep this in mind if you are on a controlled sodium diet. Tell your doctor if you are on a low salt diet.

Loss of fertility

This treatment might stop you being able to father a child. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. You may be able to store sperm before starting treatment.

  • Read more about fertility and chemotherapy
(Video) Gemcitabine plus cisplatin plus ipilimumab for metastatic urothelial cancer

Pregnancy and contraception

This treatment may harm a baby developing in the womb. It is important not to become pregnant or father a child while you're having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacisthow long you should avoid live vaccinations.

In the UK, live vaccines includerubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

  • other vaccines, but they might not give you as much protection as usual
  • the flu vaccine (as an injection)
  • the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system Gemcitabine and cisplatin (GC) | Cancer information (1) recovers from treatment.

  • Find out more about the COVID-19 vaccine and cancer

Contact with others who have had immunisations-You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to changetheir nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC)website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

(Video) Final chemo treatment for bladder cancer. Gemcitabine and Docetaxel. (June 2020)

FAQs

Can gemcitabine and cisplatin cure cancer? ›

If there is no metastatic disease (cancer is limited to bladder only and not other parts of the body), cisplatin plus gemcitabine are commonly given with the goal of cure.

How long can you take gemcitabine and cisplatin? ›

You usually have between 4 to 6 cycles of treatment taking from 3 to 6 months.

Is cisplatin the strongest chemo? ›

Presently, cisplatin is one of the most powerful chemotherapeutic drugs used for the treatment of ovarian cancer; even though resistance is typical [20]. In ovarian germ cell cancer, the use of cisplatin brings about high response rates [21].

Do you lose hair with gemcitabine? ›

On its own, gemcitabine can cause hair thinning. However, when it's given with carboplatin or paclitaxel, most people will lose all their hair, including eyebrows, eyelashes and body hair. Scalp cooling may prevent or lessen hair loss.

What is gemcitabine and cisplatin? ›

Gemcitabine and Cisplatin is a highly effective combination chemotherapy in patients with advanced cancer of the gallbladder.

How effective is gemcitabine and cisplatin? ›

Cisplatin plus gemcitabine significantly improved progression-free survival, with a median of 8.0 months (95% CI, 6.6 to 8.6) in the cisplatin–gemcitabine group as compared with 5.0 months (95% CI, 4.0 to 5.9) in the gemcitabine-only group (P<0.001).

Does gemcitabine and cisplatin cause hair loss? ›

Since the growth of normal cells may also be affected by the medicine, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may occur after treatment with gemcitabine has been stopped.

Does cisplatin make you gain weight? ›

These abnormalities in lipid metabolism are often caused by the cancer itself, but paradoxically, many cytotoxic agents used in the treatment of cancer including cisplatin also lead to weight loss despite their anticancer effects.

Does gemcitabine cause weight gain? ›

Some patients may develop fluid retention, which can cause swelling in the feet and/or ankles or face or gain weight. Fluid can also build up in the lungs and cause you to feel short of breath. Notify your healthcare team if you have any swelling, unexpected weight gain, or shortness of breath.

Will I lose my hair with cisplatin? ›

The different drugs used for chemotherapy make it more or less likely that you may lose your hair: Cisplatin – You don't usually lose much of your hair, but it may thin. Paclitaxel (taxol) – You will usually lose your hair.

What is the name of the strongest chemotherapy? ›

Doxorubicin (Adriamycin) is one of the most powerful chemotherapy drugs ever invented. It can kill cancer cells at every point in their life cycle, and it's used to treat a wide variety of cancers. Unfortunately, the drug can also damage heart cells, so a patient can't take it indefinitely.

How long does cisplatin chemo stay in your body? ›

It generally takes about 48 to 72 hours for your body to break down and/or get rid of most chemo drugs.

Does gemcitabine weaken the immune system? ›

This study shows that gemcitabine causes a profound depletion of lymphocytes. It is selectively detrimental to the humoral immune response but spares antigen-specific cellular immunity.

Can you drink alcohol with gemcitabine? ›

The drinking of alcohol (in small amounts) does not appear to affect the safety or usefulness of gemcitabine.

How long do gemcitabine side effects last? ›

The symptoms are usually self-limiting and recovery is generally within 24 to 48 hours. Less than 1% of patients discontinued use due to flu-like symptoms.

Is cisplatin stronger than gemcitabine? ›

Delivered dose-intensities were higher for cisplatin/pemetrexed (95.0% and 94.8%, respectively) than for cisplatin/gemcitabine (93.5% and 85.8%, respectively).

What is the success rate of gemcitabine? ›

In this study, we successfully reported high LPFS rates (1- and 2-year LPFS rates of 78.2% and 59.0%, respectively) in patients with LAPC treated with GPT of 67.5 GyE; the mOS was 18.7 months and the 1- and 2-year OS rates were 70.4% and 35.7%, respectively.

Can cisplatin be given before gemcitabine? ›

Recently, we described that the schedule in which cisplatin was administered 24 hours before gemcitabine produced the best pharmacological profile. Based on this and because toxicity was manageable, the schedule cisplatin 24 hours prior to gemcitabine was chosen for phase II evaluation.

Is gemcitabine a chemotherapy? ›

Gemcitabine is a chemotherapy drug used as a treatment for different types of cancer, including bladder and breast cancer. Depending on your cancer type you might have gemcitabine on its own or in combination with other cancer drugs. You might also have it alongside radiotherapy treatment.

How is cisplatin used to treat cancers? ›

Cisplatin binds to the N7 reactive center on purine residues and as such can cause deoxyribonucleic acid (DNA) damage in cancer cells, blocking cell division and resulting in apoptotic cell death.

Does cisplatin cause cough? ›

Constipation. Pain. Severe blood infection. Blockage of the airway which may cause cough, wheezing.

How can I stop my hair from falling out after chemo? ›

Can hair loss be prevented? No treatment exists that can guarantee your hair won't fall out during or after chemotherapy. Several treatments have been investigated as possible ways to prevent hair loss, but none has been absolutely effective, including: Scalp cooling caps (scalp hypothermia).

Do you lose your hair with chemo pills? ›

Chemotherapy can cause your hair to fall out, but not all chemotherapy drugs make your hair fall out. It will usually happen within 2 to 3 weeks of starting treatment. Some chemotherapy drugs can make other hair from your body fall out, such as facial hair and pubic hair.

What is the most common side effect of cisplatin? ›

This medicine often causes nausea and vomiting. However, it is very important that you continue to receive this medicine even if you begin to feel ill. Other medicines may be given to you to help with the nausea and vomiting. Ask your doctor for other ways to lessen these effects.

How do you get rid of chemo belly? ›

Balance your meals with foods less likely to cause bloating, including lean protein, (fish, chicken, lean meats), moderate healthy fats (smooth nut and seed butters, avocado) and whole grains including bread, rice, oatmeal, well-cooked barley (think soup) and well-cooked carrots, beets, green beans, squash and spinach.

Does cisplatin ever leave your body? ›

Cisplatin is cleared from your body through the kidneys. The kidney's filtering process prevents the drug from staying in your body too long and causing excessive damage to the normal cells.

How long does it take to notice weight loss in face? ›

For a weight change to show up on your face, you'd need to change your BMI by 1.33 points, the study found. That means a woman and man of average height would need to gain or lose eight pounds and nine pounds, respectively.

Does gemcitabine make you tired? ›

The following side effects are common (occurring in more than 30%) for patients taking Gemcitabine: Flu-like symptoms(muscle pain, fever, headache, chills, fatigue) Fever (within 6-12 hours of first dose) Fatigue.

How long does gemcitabine stay in the bladder? ›

The drug itself stays in your bladder for 1 to 2 hours and is then drained out through the urinary catheter, or leaves your bladder when you pass urine.

Can you drive with gemcitabine? ›

Your blood alcohol level may be above the legal limit after you have the treatment. Do not drive or operate machinery for a few hours after having this treatment, even if you feel okay. Tell the nurse, pharmacist or doctor if you notice any effects of the alcohol after having this treatment.

When I wash my hair it falls out in clumps? ›

According to a 2017 research review, an increase in clumps of hair in the shower is often due to telogen effluvium. This condition occurs more hairs are in the telogen phase and, thus, fall out more easily. The same research review above showed that the most common trigger is something many people know well: stress.

Is it normal to sleep a lot after chemo? ›

You may experience fatigue if cancer treatment damages healthy cells in addition to the cancer cells. Or fatigue might happen as your body works to repair damage caused by treatment. Some treatment side effects — such as anemia, nausea, vomiting, pain, insomnia and changes in mood — also may cause fatigue.

Is cisplatin a harsh chemo drug? ›

Cisplatin is an irritant. An irritant is a chemical that can cause inflammation of the vein through which it is given. If cisplatin escapes from the vein it can cause tissue damage. The nurse or doctor who gives cisplatin must be carefully trained.

How much should a tumor shrink after chemo? ›

With chemotherapy, the tumor might shrink, but will still remain at the next imaging. That's an important concept for some people to understand about chemotherapy. In clinical trials for solid tumors, the tumor is said to have responded if it shrinks by more than 30 percent.

What chemo drug is called the Red Devil? ›

Outpatient Oncology Drug Series: Doxorubicin Is the Infamous Red Devil.

Which cancers are most likely to recur? ›

Some cancers are difficult to treat and have high rates of recurrence. Glioblastoma, for example, recurs in nearly all patients, despite treatment. The rate of recurrence among patients with ovarian cancer is also high at 85%.

Why do you have to flush the toilet twice after chemo? ›

Small amounts of chemotherapy are present in your body fluids and body waste. If any part of your body is exposed to any body fluids or wastes, wash the exposed area with soap and water. People in your household may use the same toilet as you, as long as you flush all waste down the toilet twice with the lid down.

Can you use the same toilet as a chemo patient? ›

For 48 hours after receiving chemotherapy, patients and caregivers should follow these precautions: Flush toilets twice each time they are used. If possible, patients should use a separate toilet from others in the home. Always wash hands with soap and water after using the toilet.

How many rounds of chemo is normal? ›

During a course of treatment, you usually have around 4 to 8 cycles of treatment. A cycle is the time between one round of treatment until the start of the next. After each round of treatment you have a break, to allow your body to recover.

Can gemcitabine cure cancer? ›

Gemcitabine injection is also used to treat pancreas cancer that has advanced or spread to the other parts of the body in patients who have been previously treated with fluorouracil. Gemcitabine interferes with the growth of cancer cells, which are eventually destroyed.

What is the success rate of gemcitabine? ›

In this study, we successfully reported high LPFS rates (1- and 2-year LPFS rates of 78.2% and 59.0%, respectively) in patients with LAPC treated with GPT of 67.5 GyE; the mOS was 18.7 months and the 1- and 2-year OS rates were 70.4% and 35.7%, respectively.

Is cisplatin stronger than gemcitabine? ›

Delivered dose-intensities were higher for cisplatin/pemetrexed (95.0% and 94.8%, respectively) than for cisplatin/gemcitabine (93.5% and 85.8%, respectively).

How long can you have gemcitabine? ›

You usually have gemcitabine as a course of several cycles of treatment. This means that you have the drug and then a rest to allow your body to recover. Usually a cycle of gemcitabine is over 3 to 4 weeks (21 to 28 days). You usually have gemcitabine once a week for 2 or 3 weeks and then a week with no treatment.

Is Stage 4 cancer always terminal? ›

Is stage 4 cancer always terminal? Stage 4 cancer is not always terminal. It is usually advanced and requires more aggressive treatment. Terminal cancer refers to cancer that is not curable and eventually results in death.

Does gemcitabine make you tired? ›

The following side effects are common (occurring in more than 30%) for patients taking Gemcitabine: Flu-like symptoms(muscle pain, fever, headache, chills, fatigue) Fever (within 6-12 hours of first dose) Fatigue.

Does gemcitabine cause weight gain? ›

Some patients may develop fluid retention, which can cause swelling in the feet and/or ankles or face or gain weight. Fluid can also build up in the lungs and cause you to feel short of breath. Notify your healthcare team if you have any swelling, unexpected weight gain, or shortness of breath.

How often do bladder tumors recur? ›

Recurrence rates for bladder cancer depend on the stage of the original tumor, with 5-year recurrence rates of approximately 65% in patients with non-invasive or in situ tumors and 73% in patients with slightly more advanced disease at first diagnosis.

Does gemcitabine shrink Tumours? ›

This analysis of MPACT demonstrated significant tumor shrinkage benefit for nab-paclitaxel plus gemcitabine in both primary pancreatic and metastatic lesions, supporting ongoing evaluation of this regimen in locally advanced disease.

How do you remove a tumor from your bladder? ›

A type of thin, rigid cystoscope called a resectoscope is put into your bladder through your urethra. The resectoscope has a wire loop at the end that's used to remove any abnormal tissues or tumors. The removed tissue is sent to a lab for testing.

Can cisplatin be given before gemcitabine? ›

Recently, we described that the schedule in which cisplatin was administered 24 hours before gemcitabine produced the best pharmacological profile. Based on this and because toxicity was manageable, the schedule cisplatin 24 hours prior to gemcitabine was chosen for phase II evaluation.

Does cisplatin cause hair loss? ›

v Hair loss is minimal with cisplatin, but some patients do experience more hair loss than others. Hair growth should return upon completion of treatment.

How is cisplatin used to treat cancers? ›

Cisplatin binds to the N7 reactive center on purine residues and as such can cause deoxyribonucleic acid (DNA) damage in cancer cells, blocking cell division and resulting in apoptotic cell death.

Can you drive with gemcitabine? ›

Your blood alcohol level may be above the legal limit after you have the treatment. Do not drive or operate machinery for a few hours after having this treatment, even if you feel okay. Tell the nurse, pharmacist or doctor if you notice any effects of the alcohol after having this treatment.

Does gemcitabine weaken the immune system? ›

This study shows that gemcitabine causes a profound depletion of lymphocytes. It is selectively detrimental to the humoral immune response but spares antigen-specific cellular immunity.

Can you drink alcohol with gemcitabine? ›

The drinking of alcohol (in small amounts) does not appear to affect the safety or usefulness of gemcitabine.

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