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gemcitabine + doxorubicin is a combination chemotherapy regimen evaluated by the Medical University of South Carolina (MUSC) for the treatment of recurrent or progressive head and neck squamous cell carcinoma (HNSCC). The regimen consists of gemcitabine, a pyrimidine nucleoside analogue that inhibits DNA synthesis by targeting ribonucleoside-diphosphate reductase and competing for incorporation into DNA, and doxorubicin, an anthracycline that intercalates into DNA and inhibits topoisomerase II. This specific combination was investigated for its potential to reconstitute C18-ceramide signaling, a tumor-suppressive pathway involved in apoptosis that is frequently downregulated in head and neck cancers. In clinical studies, the regimen was administered intravenously to patients who had previously failed platinum-based therapies, with serum C18-ceramide levels serving as a novel biomarker for monitoring treatment response.
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