Gemcitabine for Adjuvant Therapy of Breast Cancer – pro

Unlike for pancreatic cancer, there is not much literature regarding the use of gemcitabine for adjuvant therapy of breast cancer. One exception is the tANGo trial. The tAnGo trial was a randomized, open-label, multicenter phase III trial examining adjuvant treatment with epirubicin (Ellence)/cyclophosphamide (Cytoxan, Neosar) for four cycles followed by paclitaxel alone or combined with gemcitabine (Gemzar) for four cycles in patients with early-stage breast cancer. Gemcitabine has been included as a partner for paclitaxel in the tAnGo trial based on high response rates, including high complete response rates, observed in phase II trials of the combination in more advanced disease and based on the tolerability and safety of the combination compared with those of other taxane-containing two-drug combinations. It was not clear how much gemcitabine added to other drugs.

At this time gemcitabine is not well supported, alone or in combination for adjuvant therapy of breast cancer.

Wardley AM, Hiller L, Howard HC, Dunn JA, Bowman A, Coleman RE, Fernando IN, Ritchie DM, Earl HM, Poole CJ; tAnGo Trial Collaborators. tAnGo: a randomised phase III trial of gemcitabine in paclitaxel-containing, epirubicin/cyclophosphamide-based, adjuvant chemotherapy for early breast cancer: a prospective pulmonary, cardiac and hepatic function evaluation. Br J Cancer. 2008 Aug 19;99(4):597-603. Epub 2008 Jul 29.

Chéreau E, Coutant C, Gligorov J, Lesieur B, Antoine M, Daraï E, Uzan S, Rouzier R. Discordance with local guidelines for adjuvant chemotherapy in breast cancer: reasons and effect on survival. Clin Breast Cancer. 2011 Mar;11(1):46-51.

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