title: A systematic review of gemcitabine and taxanes combination therapy randomized trials for metastatic breast cancer.
abstract: OBJECTIVE
  Gemcitabine/taxanes-based combination shows anti-tumor activity for the treatment of metastatic breast cancer, but there is a debate regarding the advantages of gemcitabine and taxanes regimens as a first-line or second-line treatment for metastatic breast cancer. Here we conducted a systematic review and meta-analysis to compare the efficacy and toxicity for patients receiving chemotherapy with or without GT-based regimens.
  
  
  METHODS
  The randomized controlled trials were performed by searching Pubmed, MEDLINE, EMBASE, and conference proceedings. We identified eight randomized controlled trials and then extracted and combined the data using to calculate hazard ratios (HR). The primary outcomes were progression-free survival (PFS) and time to progression (TTP). The secondary outcomes were overall survival (OS) and acute toxicity. A meta-analysis was performed using Review Manager Version 4.2.
  
  
  RESULTS
  Eight eligible trails were identified. These studies involved 2234 patients with metastatic breast cancer, (1122 patients received GT-based combination regimen and 1112 patients received a regimen without the combination). A fixed-effects model meta-analysis showed that ORR and TTP are superior for GT-treated patients ORR (OR = 1.28, 95% CI 1.07-1.53), TTP (HR = 0.80; 95% CI 0.71-0.89). And GT-based combination significantly improved OS in the first-line subgroup (HR = 0.84; 95% CI 0.71-0.99). However, there were significant differences regarding acute hematological toxicity, particularly thrombocytopenia.
  
  
  CONCLUSIONS
  Gemcitabine/taxanes-treated patients with metastatic breast cancer showed a significant improvement in the ORR, TTP and OS (first-line background) compared to patients not treated with the combination regimen.
authors.affiliation: Department of Oncology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, No. 107 West Yangjiang Road, Guangzhou, 510120 PR China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Hu
authors.affiliation: Department of Oncology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, No. 107 West Yangjiang Road, Guangzhou, 510120 PR China.
authors.forename: Jun-Xia
authors.initials: JX
authors.lastname: Jiang
authors.affiliation: Department of Oncology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, No. 107 West Yangjiang Road, Guangzhou, 510120 PR China ; Department of Oncology, Yiyang Central Hospital of Hunan Province, No.232 West Wuyi Road, Yiyang, 413000 Hunan Province PR China.
authors.forename: Long
authors.initials: L
authors.lastname: Luo
authors.affiliation: Department of Oncology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, No. 107 West Yangjiang Road, Guangzhou, 510120 PR China.
authors.forename: Xing
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Oncology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, No. 107 West Yangjiang Road, Guangzhou, 510120 PR China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Lin
authors.affiliation: Department of Oncology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, No. 107 West Yangjiang Road, Guangzhou, 510120 PR China.
authors.forename: Xiao-Xiao
authors.initials: XX
authors.lastname: Dinglin
authors.affiliation: Department of Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 West Yangjiang Road, Guangzhou, 510120 PR China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Pharmaceutical department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 West Yangjiang Road, Guangzhou, 510120 PR China.
authors.forename: Jun-Yan
authors.initials: JY
authors.lastname: Wu
authors.affiliation: Department of Oncology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, No. 107 West Yangjiang Road, Guangzhou, 510120 PR China.
authors.forename: He-Rui
authors.initials: HR
authors.lastname: Yao
keywords: Gemcitabine; Metastatic breast cancer; Systematic review; Taxanes