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This combination regimen consists of the antimetabolite gemcitabine paired with a platinum-based alkylating agent, either cisplatin or carboplatin. Gemcitabine is a nucleoside analog that inhibits DNA synthesis by inhibiting ribonucleotide reductase and by being incorporated into DNA, which subsequently inhibits DNA polymerase and causes chain termination. Cisplatin and carboplatin are platinum compounds that form covalent adducts with DNA, creating inter-strand and intra-strand cross-links that impede DNA replication and transcription, triggering apoptosis. This doublet chemotherapy is a standard-of-care first-line treatment for advanced non-small cell lung cancer (NSCLC). In the context of the Merck Sharp & Dohme LLC trial (NCT00039156), this regimen was evaluated to measure metabolic response using [18F]-fluorodeoxyglucose (FDG) uptake via PET imaging in patients with Stage IIIB or IV NSCLC.
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