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Abstract
Advances in breast cancer continue to focus on the development of novel agents as
well as the development of novel combinations, with the major therapeutic goal of
treatment strategies revolving around improving response rates, delaying the time
to disease progression, palliating symptoms, and improving quality of life. The taxanes
are recognized as some of the most active single agents in breast cancer and demonstrate
remarkable activity with manageable toxicity in combination with gemcitabine. Gemcitabine,
a novel S-phase specific cytidine nucleoside analogue of deoxycytidine, has broad
antitumor activity with significant monotherapy activity in breast cancer, with response
rates ranging from 22% to 42% depending on the pretreatment characteristics of the
patients. In general, gemcitabine's favorable single-agent activity and novel mechanism
of action, in addition to its largely nonoverlapping toxicities, have facilitated
its further development in combination with a variety of chemotherapy agents, including
the taxanes. Several phase I and II trials have reported impressive activity for the
gemcitabine/taxane doublet with the suggestion of clinical synergism between these
2 classes of agents. Given the remarkable and durable activity reported for this doublet,
subsequent phase II trials have focused on optimizing doses and schedules. Unmistakably,
these trial results are clear improvements over the single-agent activity of the taxanes
in metastatic breast cancer, with the recently reported phase III trial comparing
gemcitabine plus paclitaxel versus paclitaxel alone clearly reinforcing the superior
outcomes demonstrated for the combination. Either as a single agent or in combination
with the taxanes, gemcitabine remains a rational choice for the treatment of breast
cancer.
Key words
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Article info
Publication history
Accepted:
December 19,
2003
Received in revised form:
December 16,
2003
Received:
October 24,
2003
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© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
