First-line treatment for locally advanced or metastatic
non-small cell lung cancer (as monotherapy in elderly
patients and in palliative treatment; otherwise in
combination with cisplatin) | Treatment of locally
advanced or metastatic pancreatic cancer | Treatment of
advanced or metastatic bladder cancer (in combination
with cisplatin) | Treatment of locally advanced or
metastatic epithelial ovarian cancer which has relapsed
after a recurrence-free interval of at least 6 months
following previous platinum-based therapy (in
combination with carboplatin) | Treatment of metastatic
breast cancer which has relapsed after previous
chemotherapy including an anthracycline (in
combination with paclitaxel)
▶BY INTRAVENOUS INFUSION
▶Adult: (consult local protocol)
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NICE decisions
▶Gemcitabine for the treatment of pancreatic cancer (May
2001) NICE TA25
Gemcitabine is an option for first-line chemotherapy for
patients with advanced or metastatic adenocarcinoma of
the pancreas and a Karnofsky score of at least 50
[Karnofsky score is a measure of the ability to perform
ordinary tasks].
Gemcitabine is not recommended for patients who can
have potentially curative surgery. There is insufficient
evidence to support its use for second-line treatment of
pancreatic adenocarcinoma.
www.nice.org.uk/guidance/ta25
▶Gemcitabine for the treatment of metastatic breast cancer
(January 2007) NICE TA116
Gemcitabine, in combination with paclitaxel, is an option
for the treatment of metastatic breast cancer only when
docetaxel monotherapy or docetaxel plus capecitabine are
also considered appropriate.
www.nice.org.uk/guidance/ta116
▶Bevacizumab in combination with gemcitabine and
carboplatin for the treatment of the first recurrence of
platinum-sensitive advanced ovarian cancer (May 2013)
NICE TA285
Bevacizumab in combination with gemcitabine and
carboplatin is not recommended within its marketing
authorisation, that is, for the treatment of the first
recurrence of platinum-sensitive advanced ovarian cancer
(including fallopian tube and primary peritoneal cancer)
that has not been previously treated with bevacizumab or
other vascular endothelial growth factor (VEGF) inhibitors
or VEGF receptor-targeted agents.
www.nice.org.uk/guidance/ta285
▶Topotecan, pegylated liposomal doxorubicin hydrochloride,
paclitaxel, trabectedin and gemcitabine for treating recurrent
ovarian cancer (April 2016) NICE TA389
Gemcitabine, in combination with carboplatin, is not
recommended for treating the first recurrence of
platinum-sensitive ovarian cancer.
Patients currently receiving gemcitabine in combination
with carboplatin should have the option to continue their
treatment until they and their clinician consider it
appropriate to stop.
www.nice.org.uk/guidance/ta389
▶Paclitaxel as albumin-bound nanoparticles with gemcitabine
for untreated metastatic pancreatic cancer (September 2017)
NICE TA476
Gemcitabine with paclitaxel as albumin-bound
nanoparticles (nab-paclitaxel) is recommended as an
option for untreated metastatic adenocarcinoma of the
pancreas in adults, only if:
. other combination chemotherapies are unsuitable and
they would otherwise have gemcitabine monotherapy,
and
. the manufacturer provides nab-paclitaxel with the
discount agreed in the patient access scheme.
Patients whose treatment with nab-paclitaxel was started
before this guidance was published, should have the
option to continue treatment until they and their NHS
clinician consider it appropriate to stop.
www.nice.org.uk/guidance/ta476
Scottish Medicines Consortium (SMC) decisions
The Scottish Medicines Consortium has advised (December
2006) that gemcitabine (Gemzar ®) is accepted for
restricted use within NHS Scotland for the treatment of
metastatic breast cancer, which has relapsed following
previous chemotherapy including an anthracycline (unless
contra-indicated).
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