Gemcitabine and anthracyclines in breast cancer

Anthracyclines are among the most active drugs in breast cancer. Gemcitabine is a novel agent that has also shown good antitumor activity in advanced breast cancer. This compound has a favorable toxicity profile, no apparent multidrug resistance, and retains its activity in anthracycline-pretreated patients. Therefore, it was logical to combine gemcitabine with anthracyclines. The combinations of gemcitabine and anthracyclines (doxorubicin, liposomal doxorubicin, epirubicin) have been tested in a few phase I and II studies. Generally, these combinations have been shown to be feasible and well tolerated. The pharmacokinetics of gemcitabine and anthracyclines was not affected by their combined use. Myelosuppression was the most common adverse event; neutropenia was easily reversible. Data from phase II clinical studies suggest that gemcitabine/anthracycline combinations are relatively effective in first- or second-line therapy for women with locally advanced and metastatic breast cancer. Future randomized clinical trials are warranted to further elucidate the role of these regimens in breast cancer care.