Gemcitabine single or combination chemotherapy in post anthracycline and taxane salvage treatment of metastatic breast cancer: retrospective analysis of 124 patients.
OBJECTIVE
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).


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 approximately 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 approximately 9.6 months) and the median time to progression was 3.1 months (95% CI: 2.0 approximately 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.
Kim
Min Kyoung
MK
Division of Oncology, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim
Sung-Bae
SB
Ahn
Jin Hee
JH
Lee
Soon Im
SI
Ahn
Sei-Hyun
SH
Son
Byung Ho
BH
Gong
Gyungyub
G
Kim
Hak-Hee
HH
Lee
Jung-Shin
JS
Kang
Yoon-Koo
YK
Kim
Woo Kun
WK