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Systemic Anti-Cancer Therapy Regimen Library

LYM - vinORELBine and gemcitabine

Treatment Overview

Usually 4 to 6 cycles.


This regimen contains a medicine where one or more biosimilars may exist. Any biosimilars used have been reviewed by the regulator (Medsafe) and relevant specialists were consulted nationally. Where regulators, in consultation with relevant specialists, have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably.

Cycles 1 to 6 - 21 days

Cycle length:
21

Some centres may choose to include a steroid (e.g. dexamethasone) with this regimen.

Cycle details

Cycles 1 to 6 - 21 days

Medication Dose Route Days Max Duration
vinORELBine * 25 mg/m² intravenous 1, 8 10 minutes
gemcitabine * 1000 mg/m² intravenous 1, 8 30 minutes

Some centres may choose to include a steroid (e.g. dexamethasone) with this regimen.

Full details

Cycles 1 to 6 - 21 days

Day: 1

Medication Dose Route Max duration Details
vinORELBine * 25 mg/m² intravenous 10 minutes
Instructions:
  • Diluted in a minibag.
  • FOR INTRAVENOUS USE ONLY – fatal if given by any other routes.
  • Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
gemcitabine * 1000 mg/m² intravenous 30 minutes

Day: 8

Medication Dose Route Max duration Details
vinORELBine * 25 mg/m² intravenous 10 minutes
Instructions:
  • Diluted in a minibag.
  • FOR INTRAVENOUS USE ONLY – fatal if given by any other routes.
  • Warning vesicant—ensure vein is patent prior to administration, administer vesicant as per institutional policy and monitor for signs of extravasation throughout administration.
gemcitabine * 1000 mg/m² intravenous 30 minutes

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Constipation risk: laxatives are usually prescribed
Emetogenicity: Low
Growth factor support: Variable
Irradiated blood components: Variable
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis may be considered

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

Growth factor support: Consider primary prophylaxis for patients over 64 years of age or other high-risk patients.

Irradiated blood components: Required for Hodgkin lymphoma patients at all stages of disease and therapy. Continue indefinitely.

References

Pasricha, S. R., A. Grigg, J. Catalano, et al. 2008. "A multicenter phase 2 study of risk-adjusted salvage chemotherapy incorporating vinorelbine and gemcitabine for relapsed and refractory lymphoma." Cancer 113(11):3192-3198., PMID: 18932253

Spencer, A., K. Reed and C. Arthur. 2007. "Pilot study of an outpatient-based approach for advanced lymphoma using vinorelbine, gemcitabine and filgrastim." Intern Med J 37(11):760-766., PMID: 17542998

Papageorgiou, E. S., P. Tsirigotis, M. Dimopoulos, et al. 2005. "Combination chemotherapy with gemcitabine and vinorelbine in the treatment of relapsed or refractory diffuse large B-cell lymphoma: a phase-II trial by the Hellenic Cooperative Oncology Group." Eur J Haematol 75(2):124-129., PMID: 16000128

Muller-Beissenhirtz, H., C. Kasper, H. Nuckel, et al. 2005. "Gemcitabine, vinorelbine and prednisone for refractory or relapsed aggressive lymphoma, results of a phase II single center study." Ann Hematol 84(12):796-801., PMID: 16041531

Perrotti, A. P., P. Niscola, A. Tendas, et al. 2008. "Vinorelbine and gemcitabine as salvage treatment in advanced and very poor prognosis non-Hodgkin's lymphoma patients." Ann Hematol 87(6):493-494., PMID: 18074132

Shang EY, Solimando DA Jr, Waddell JA. Gemcitabine and Vinorelbine (GemVin) Regimen. Hosp Pharm. 2014 Jun;49(6):508-16. doi: 10.1310/hpj4906-508. , PMID: 24958967

Sivam, V., L. Cook, G. Hughes, et al. 2012. "Gemcitabine and vinorelbine chemotherapy for refractory or relapsing aggressive non-Hodgkin lymphoma." Hematol Oncol 30(4):214-215., PMID: 22422565

New Zealand Blood Service Transfusion Medicine Handbook Third Edition, 2016 https://www.nzblood.co.nz/assets/Transfusion-Medicine/PDFs/111G122.pdf (accessed 16 June 2022).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.