Docetaxel/gemcitabine: salvage chemotherapy in anthracycline-pretreated patients with advanced breast cancer.
Docetaxel (Taxotere) and gemcitabine (Gemzar) are active agents against breast cancer. Several phase I studies evaluated different schedules of their combination and clearly demonstrated that docetaxel and gemcitabine can be safely combined in either an every 3-week schedule or in a weekly and biweekly schedule. The toxicity profiles of these combinations were mainly grade 3 and 4 neutropenia and asthenia. Phase I studies also suggested that the docetaxel/gemcitabine combinations are active regimens in pretreated patients with advanced breast cancer. Three phase II studies of patients previously treated with anthracycline-based chemotherapy reported a mean objective response rate of 46% and a mean overall survival of 13.5 months. Two of these trials enrolled patients with anthracycline-resistant or anthracycline-refractory disease; the objective responses using docetaxel/gemcitabine combination were 36% to 55% and 54%, respectively. It is noteworthy that objective responses were also achieved with this regimen in some patients who progressed while receiving taxane-based, front-line chemotherapy. These efficacy results were obtained with a mild toxicity profile. Adverse events were of short duration and easily manageable. Further studies are needed to evaluate this combination as front-line chemotherapy as well as second-line in well-defined subgroups of patients with advanced breast cancer. Furthermore, the combination should be compared with other more standard or investigational regimens.
Georgoulias
V A
VA
Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece. georgoul@med.uch.gr
D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use*; D000077143:Docetaxel; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D016879:Salvage Therapy; D043823:Taxoids; D000093542:Gemcitabine
D000903:Antibiotics, Antineoplastic; D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D017239:Paclitaxel; D000093542:Gemcitabine