Gemcitabine plus paclitaxel in breast cancer

The combining of gemcitabine and paclitaxel in chemotherapy for metastatic breast cancer is supported by sound evidence of single-agent activity, beneficial pharmacologic interaction, and largely non-overlapping toxicities. In phase II studies in both heavily pretreated patients and chemotherapy-naive patients, the combination has produced remarkably high rates of response and has been exceptionally well tolerated. A recent phase III trial of the combination as first-line treatment for metastatic breast cancer showed significant improvements in objective response, time to disease progression, and overall survival compared with paclitaxel alone, leading to the approval of gemcitabine in combination with paclitaxel for this indication. The combination was very well tolerated and was not associated with any adverse impact in quality of life compared with paclitaxel alone. Continued investigation of the role of gemcitabine/taxane combinations in early and advanced breast cancer is ongoing, including additional investigation of biweekly schedules and use of the combination as part of triplet therapy with trastuzumab.