title: Gemcitabine single or combination chemotherapy in post anthracycline and taxane salvage treatment of metastatic breast cancer: retrospective analysis of 124 patients.
abstract: 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.
authors.affiliation: Division of Oncology, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Min Kyoung
authors.initials: MK
authors.lastname: Kim
authors.forename: Sung-Bae
authors.initials: SB
authors.lastname: Kim
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Ahn
authors.forename: Soon Im
authors.initials: SI
authors.lastname: Lee
authors.forename: Sei-Hyun
authors.initials: SH
authors.lastname: Ahn
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Son
authors.forename: Gyungyub
authors.initials: G
authors.lastname: Gong
authors.forename: Hak-Hee
authors.initials: HH
authors.lastname: Kim
authors.forename: Jung-Shin
authors.initials: JS
authors.lastname: Lee
authors.forename: Yoon-Koo
authors.initials: YK
authors.lastname: Kang
authors.forename: Woo Kun
authors.initials: WK
authors.lastname: Kim