Cancer Res Treat.  2006 Dec;38(4):206-213.

Gemcitabine Single or Combination Chemotherapy in Post Anthracycline and Taxane Salvage Treatment of Metastatic Breast Cancer: Retrospective Analysis of 124 Patients

• Kim MK
• Kim SB
• Ahn JH
• Lee SI
• Ahn SH
• Son BH
• Gong G
• Kim HH
• Lee JS
• Kang YK
• Kim WK

Abstract

PURPOSE
To evaluate the efficacy of gemcitabine- based chemotherapy, particularly in patients with anthracycline- and taxane-pretreated 2(nd)-line or greater metastatic breast cancer, and to compare gemcitabine monotherapy (G) with two gemcitabine-based doublets, gemcitabine/ vinorelbine (GV) and gemcitabine/capecitabine (GX).
MATERIALS AND METHODS
Of 124 consecutive patients who progressed after anthracycline- and taxane-containing chemotherapy, 58 received G alone, 38 received GV, and 28 received GX; their outcomes were analyzed retrospectively.
RESULTS
The median number of prior metastatic chemotherapy regimens was 2 (range 0~4). Visceral metastases were observed in 65 patients (51.4%). The overall response rate was 19.3% (21 partial responses). After a median follow-up period of 21.4 months, the overall survival was 7.6 months (95% CI: 5.5~9.6 months) and the median time to progression was 3.1 months (95% CI: 2.0~4.2 months). Compared with monotherapy (G), combination therapy with vinorelbine or capecitabine (GV/ GX) was associated with a significantly higher response rate (8.2% vs. 28.3%, p=0.008) and a significantly longer median time to progression (2.8 vs. 3.5 months; p=0.028), but overall survival did not differ between the groups (7.4 vs. 8.2 months, respectively; p=0.54). Most of the adverse treatment-related events were mild to moderate in intensity. The most common adverse event was hematologic toxicity. Multivariate analysis showed that poor performance status and a short disease-free interval were independent prognostic factors for impaired overall survival.
CONCLUSIONS
The combination of gemcitabine with vinorelbine or capecitabine was an active and well-tolerated treatment option for taxane- and anthracycline-pretreated 2(nd)-line or greater metastatic breast cancer patients, and gemcitabine-based doublets were more beneficial than gemcitabine monotherapy in alleviating symptoms for these patients.

Keyword

Gemcitabine; Chemotherapy; Combination; Breast neoplasms

MeSH Terms

Breast Neoplasms*
Breast*
Drug Therapy
Drug Therapy, Combination*
Follow-Up Studies
Humans
Multivariate Analysis
Neoplasm Metastasis
Retrospective Studies*
Capecitabine

Figure

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  Fig. 1 Kaplan-Meier curves of time to progression and overall survival for all patients (n=124). TTP, time to progression; OS, overall survival.

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  Fig. 2 Kaplan-Meier curves of time to progression according to combination or monotherapy (p=0.028). G, gemcitabine; GV, gemcitabine/vinorelbine; GX, gemcitabine/capecitabine.

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  Fig. 3 Kaplan-Meier curves of overall survival according to combination or monotherapy (p=0.54). G, gemcitabine; GV, gemcitabine/vinorelbine; GX, gemcitabine/capecitable.

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