[Metastatic breast cancer: new chemotherapy regimens with taxanes]

Patients with breast cancer are frequently treated with anthracyclines and/or taxanes, which are among the most useful agents in this disease. Therefore, it is increasingly difficult to find active regimens in heavily pretreated patients. Gemcitabine is a cytosine arabinoside prodrug analog which shows significant activity, as single agent, in metastatic breast cancer. The combination of gemcitabine and taxanes is particularly valuable because of the different mechanisms of action of each drug and their non-everlapping toxicities. During the last years, we have carried out several trials with gemcitabine in combination with either docetaxel or paclitaxel. The combination of gemcitabine and docetaxel in 53 previously treated patients resulted in 53% response rate (RR) with a median time to progression of 7.5 months, and an overall survival of 16.5 months. When gemcitabine was combined with paclitaxel in a biweekly schedule in 34 evaluable patients with prior exposure to several chemotherapy regimens, RR was 53%. It was 50% in patients previously treated with docetaxel. Toxicity was generally mild to moderate. Paclitaxel plus gemcitabine given as an every 2-weeks schedule is a practical, well tolerated and active regimen in advanced breast carcinoma, which deserves further evaluation in less heavily pretreated patients.