Lopez M
Istituto Nazionale Tumori Regina Elena, Roma.
Clin Ter. 2005 Nov-Dec;156(6):311-5.
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.
乳腺癌患者经常接受蒽环类药物和/或紫杉烷类药物治疗，这些药物是治疗该疾病最有效的药物之一。因此，在经过大量预处理的患者中找到有效的治疗方案越来越困难。吉西他滨是一种阿糖胞苷前体药物类似物，作为单一药物在转移性乳腺癌中显示出显著活性。吉西他滨与紫杉烷类药物联合使用特别有价值，因为每种药物的作用机制不同且毒性不重叠。在过去几年中，我们进行了几项吉西他滨与多西他赛或紫杉醇联合使用的试验。53例先前接受过治疗的患者使用吉西他滨与多西他赛联合治疗，有效率（RR）为53%，中位疾病进展时间为7.5个月，总生存期为16.5个月。在34例先前接受过多种化疗方案治疗的可评估患者中，吉西他滨与紫杉醇每两周一次联合用药的RR为53%。在先前接受多西他赛治疗的患者中，RR为50%。毒性一般为轻度至中度。紫杉醇加吉西他滨每2周给药一次的方案在晚期乳腺癌中是一种实用、耐受性良好且有效的治疗方案，值得在预处理程度较轻的患者中进一步评估。
