Gemcitabine and platinum-based chemotherapy in metastatic breast cancer

Although anthracyclines and the taxanes comprise the most active first-line cytotoxic treatments in patients with hormone-insensitive or life-threatening metastatic breast cancer, many patients progress and require other chemotherapeutic agents. Development of new combinations and/or agents is thus needed. Gemcitabine (Gemzar) and platinum compounds have been employed as single agents, and the addition of gemcitabine to the platinums results in significant clinical benefit and response rates. Correlative biologic studies are expected from several already-reported trials and may help elucidate predictive factors for both response and toxicity when combining gemcitabine and the platinums. Trials incorporating these doublets in earlier stages of breast cancer or in the neoadjuvant setting may further elucidate their role in breast cancer treatment.