Gemcitabine and paclitaxel in metastatic breast cancer: a review.
Gemcitabine (Gemzar) and paclitaxel are active drugs in the treatment of metastatic breast cancer. Phase I clinical trials data have suggested that the gemcitabine plus paclitaxel combination is safe in breast cancer patients. Two doses/administration schedules have been preferred in subsequent phase II and III trials: gemcitabine on days 1 and 8 plus a taxane on day 1, every 3 weeks; or gemcitabine plus a taxane on days 1 and 14, every 4 weeks. In phase II trials, 114 of 221 patients (52%) responded to gemcitabine/paclitaxel therapy. Response rates were lower among patients who received previous chemotherapy for metastatic disease (response rates: 45%, second line and 70%, first line). Toxicity of gemcitabine/paclitaxel regimens has generally been low, with few cases of neutropenia or nonhematologic toxicity. Results of the randomized phase III registration trial show a clear advantage for gemcitabine plus paclitaxel over paclitaxel alone in time to disease progression, objective response, and overall survival. Triplet combinations, in which an anthracycline is added to gemcitabine/paclitaxel, are being explored in the metastatic and neoadjuvant settings.
Colomer
Ramon
R
Medical Oncology Division, Institut Català d'Oncologia, Girona, Spain. rcolomer@icogirona.scs.es
D018943:Anthracyclines / Q000008:administration & dosage; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D000093542:Gemcitabine
D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D003841:Deoxycytidine; D017239:Paclitaxel; D000093542:Gemcitabine