title: High efficacy of gemcitabine and cisplatin in patients with predominantly anthracycline- and taxane-pretreated metastatic breast cancer.
abstract: BACKGROUND
  Effective and tolerable regimens are sought specifically in patients who have been pretreated with anthracyclines and taxanes. Gemcitabine and cisplatin demonstrated synergistic activity in vitro and provides a new mechanism of drug interaction.
  
  
  METHODS
  Previously treated patients with metastatic breast cancer (MBC) were enrolled in a multicentre phase II study. Treatment consisted of gemcitabine (750 mg/m(2)) and cisplatin (30 mg/m(2)) given on day 1 and 8 every 3 weeks.
  
  
  RESULTS
  Thirty-eight patients were recruited, all of whom had previously received chemotherapy (35 pretreated with taxanes, 33 pretreated with anthracyclines). A median of 5 cycles of the study treatment was delivered. There were 2 complete and 13 partial responses, for an overall response rate of 40% (95% confidence interval: 23-56%). Thirteen patients (35%) had stable disease. Tumour response appeared independent of previously applied chemotherapy. Median time-to-progression was 6 months and median overall survival was 13.5 months. Main toxicities were leucopenia and thrombocytopenia (grade 3/4 in 26 and 16% of cycles, respectively). Non-haematological toxicity was rarely severe.
  
  
  CONCLUSIONS
  Combination chemotherapy with gemcitabine and cisplatin given on 2 out of 3 weeks is well tolerated and active in heavily pretreated patients with MBC, even after prior exposure to anthracyclines and taxanes.
authors.affiliation: Department of Medicine III, Klinikum Grosshadern, University of Munich, Marchioninistr. 15, 81377, Munich, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Heinemann
authors.forename: H J
authors.initials: HJ
authors.lastname: Stemmler
authors.forename: A
authors.initials: A
authors.lastname: Wohlrab
authors.forename: D
authors.initials: D
authors.lastname: Bosse
authors.forename: C
authors.initials: C
authors.lastname: Losem
authors.forename: S
authors.initials: S
authors.lastname: Kahlert
authors.forename: G
authors.initials: G
authors.lastname: Rauthe
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D001952:Bridged-Ring Compounds / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018450:Disease Progression; D005260:Female; D006801:Humans; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D016879:Salvage Therapy; D043823:Taxoids / Q000627:therapeutic use*; D013997:Time Factors; D000093542:Gemcitabine
chemical_list: D018943:Anthracyclines; D001952:Bridged-Ring Compounds; D043823:Taxoids; D003841:Deoxycytidine; C080625:taxane; D002945:Cisplatin; D000093542:Gemcitabine