The role of gemcitabine in the treatment of ovarian cancer.

Epithelial ovarian cancer remains the number one gynecologic killer in the Western world. The standard therapeutic approach for patients with advanced-stage epithelial ovarian cancer has been cytoreductive surgery followed by combination chemotherapy. Despite improvements in outcome associated with carboplatin/ paclitaxel-based chemotherapy, most patients with advanced ovarian cancer are not cured by this combination. Gemcitabine has been shown to be an active agent in the treatment of patients with recurrent ovarian cancer. The response rate of approximately 19% noted with single-agent gemcitabine is associated with acceptable toxicity. In addition, gemcitabine can be combined with other active agents, including carboplatin and paclitaxel. Clinical trials will be performed to evaluate whether a three-drug combination including gemcitabine will be superior to treatment with the standard approach of carboplatin plus paclitaxel.