The most frequent toxic effects, which are more pronounced following higher doses or when liposomal doxorubicin is given every 3 weeks, include neutropenia, stomatitis, and hand-foot syndrome. Oral and cutaneous toxic effects completely resolve within 5 weeks of drug administration. Nausea is minimal and alopecia rarely occurs. Gemcitabine, a pyrimidine antimetabolite with similarities to cytosine arabinoside, has shown activity in patients with recurrent ovarian cancer. Leucopenia, anemia, and thrombocytopenia are the most common toxic effects.
Many patients report transient, flu-like symptoms following drug administration.
Other toxic effects, including nausea, are usually mild. Regrowth of hair lost during previous chemotherapy has been reported following treatment with gemcitabine. Topotecan, a topoisomerase I inhibitor, has been extensively evaluated as a single agent in patients with recurrent epithelial ovarian cancer. Substantial myelosuppression follows administration. Other toxic effects include nausea, vomiting, alopecia, and, rarely, asthenia.