gemcitabine + doxorubicin + paclitaxel + cisplatin

This refers to a specific sequential adjuvant chemotherapy regimen developed by Memorial Sloan Kettering Cancer Center (MSKCC) for patients with completely resected locally advanced urothelial carcinoma (bladder cancer). The regimen is administered in two distinct phases: an initial combination of gemcitabine and doxorubicin (AG), followed by a subsequent combination of paclitaxel and cisplatin. This sequential approach is designed to utilize multiple non-cross-resistant cytotoxic agents to eliminate residual microscopic disease after surgery. Gemcitabine acts as a nucleoside analog that inhibits DNA synthesis; doxorubicin is an anthracycline that intercalates DNA and inhibits topoisomerase II; paclitaxel is a taxane that stabilizes microtubules to prevent cell division; and cisplatin is a platinum-based agent that forms DNA cross-links. The regimen often includes filgrastim (G-CSF) as supportive care to manage neutropenia.

Brand names

GemzarAdriamycinTaxolPlatinol

Other names

Sequential Adjuvant Chemotherapy for Locally Advanced Urothelial CarcinomaGemcitabine-Doxorubicin followed by Paclitaxel-CisplatinMSKCC Sequential Adjuvant Regimen