J Breast Cancer.  2014 Dec;17(4):339-343. 10.4048/jbc.2014.17.4.339.

Outcomes of Palliative Weekly Low-Dose Gemcitabine-Cisplatin Chemotherapy in Anthracycline- and Taxane- Pretreated Metastatic Breast Cancer Patients

• Kim JS
• Park IH
• Lee KS
• Ro J

• KMID: 2176124
• DOI: http://doi.org/10.4048/jbc.2014.17.4.339

Abstract

PURPOSE
The combination of gemcitabine and cisplatin (GP) has been shown to be safe and efficacious for patients with metastatic breast cancer (MBC), pretreated with anthracyclines and taxanes. We assessed the efficacy and safety of weekly low-dose GP in patients with MBC.
METHODS
We collected clinicopathological data from MBC patients who had been treated with gemcitabine, 800 mg/m2 plus cisplatin, 30 mg/m2 intravenously, on days 1 and 8 every 3 weeks, between January 2001 and November 2011 in Korea.
RESULTS
The analysis included 294 patients previously treated anthracycline-xand taxane-based chemotherapies prior to GP (median age, 48 years [range, 28-78 years]; median follow-up duration, 63.9 months). Seventeen patients (5.8%) discontinued GP because of toxicities. The median progression-free survival (PFS) was 3.9 months (95% confidence interval [CI], 3.394.4 months) and the median overall survival (OS) was 27.7 months (95% CI, 17.6-37.8 months) months. Statistically significant factors for PFS were performance status (Eastern Cooperative Oncology Group, > or =2 vs. <2; hazard ratio [HR], 1.37; 95% CI, 1.02-1.85; p=0.037), distant disease-free interval (DDFI; < or =2 years vs. >2 years; HR, 1.66; 95% CI, 1.28-1.95, p<0.001), time interval from the diagnosis of metastasis to GP therapy (< or =1 year vs. >1 year; HR, 1.48; 95% CI, 1.13-1.95, p<0.001), and presence of brain metastasis (HR, 1.47; 95% CI, 1.03-2.10; p=0.031). Similarly, DDFI (< or =2 years vs. >2 years; HR, 2.07; 95% CI, 1.36-3.14; p<0.001) and the presence of brain metastasis (HR, 2.14; 95% CI, 1.27-3.61; p=0.004) were important factors for OS after GP treatment.
CONCLUSION
Weekly low-dose GP chemotherapy appears safe and effective for heavily pretreated MBC patients.

Keyword

Breast neoplasms; Drug therapy; Neoplasm metastasis

MeSH Terms

Anthracyclines
Brain
Breast Neoplasms*
Cisplatin
Diagnosis
Disease-Free Survival
Drug Therapy*
Follow-Up Studies
Humans
Korea
Neoplasm Metastasis
Taxoids
Anthracyclines
Cisplatin
Taxoids

Figure

• 

  Figure 1 CONSORT diagram. MBC=metastatic breast cancer; NCC=National Cancer Center, Korea.

• 

  Figure 2 Progression-free survival (PFS) and overall survival (OS) after gemcitabine and cisplatin (GP) treatment. (A) Median PFS was 3.9 months (95% confidence interval [CI], 3.3-4.4 months). (B) Median OS was 27.7 months (95% CI, 17.6-37.8 months). MBC=metastatic breast cancer; cum=cumulative.

• 

  Figure 3 Progression-free survival (PFS) and overall survival (OS) according to receptor status in the patients with human epidermal growth factor receptor 2 (HER2)-negative tumors. (A) Median PFS in patients with estrogen receptor (ER)-/HER2- tumors was 3.3 months, and PFS of ER+/HER2- was 4.3 months. (B) Median OS in patients with ER-/HER2- tumors was 7.6 months and OS in patients with ER+/HER2- tumors was 10.1 months. cum=cumulative.

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