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Hydroxychloroquine + gemcitabine is a combination of two small molecule drugs used primarily in investigational settings for the treatment of pancreatic cancer and other solid tumors. Hydroxychloroquine is an antimalarial agent that inhibits autophagy by blocking the fusion of autophagosomes with lysosomes, thereby disrupting a key survival mechanism in cancer cells. Gemcitabine is a nucleoside analog that interferes with DNA synthesis, leading to cell death, and is widely used as chemotherapy for various cancers. The rationale for combining these agents lies in overcoming chemoresistance mediated by autophagy; hydroxychloroquine sensitizes tumor cells to gemcitabine-induced cytotoxicity. Clinical trials have shown this combination can improve pathologic tumor response and serum biomarker response in pancreatic adenocarcinoma, though improvements in overall survival have not been consistently demonstrated[1][2][5].
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