Cancer Treatment Today

Chemotherapy remains a mainstay in the treatment of breast cancer. Anthracyclines and taxanes are two classes of chemotherapy agents that are commonly used to treat breast cancer. Because treatment options are limited for patients whose cancer recurs following use of anthracyclines and taxanes, researchers continue to evaluate newer and different chemotherapy combinations in an effort to improve the duration of survival for these patients.

According to an article recently published in Lancet Oncology, the addition of the chemotherapy agent Gemzar® (gemcitabine) to Navelbine® (vinorelbine) improves progression-free survival, but not overall survival, compared with Navelbine alone in women with breast cancer whose disease has progressed following prior chemotherapy.

Researchers from Spain recently conducted a Phase III trial referred to as the GEICAM trial to compare different chemotherapy regimens in women with recurrent breast cancer. This trial included 252 women who had previously been treated with anthracyclines and taxanes and had experienced a recurrence. One group was treated with Gemzar and Navelbine, while the other group was treated with Navelbine.

Median progression-free survival was longer at six months for patients treated with Gemzar/Navelbine compared with four months for those treated with Navelbine only.
Overall survival was approximately 16 months for both groups of patients.
Anticancer responses were 36% for patients treated with Gemzar/Navelbine and 26% for patients treated with Navelbine. The researchers concluded that the addition of Gemzar to Navelbine improves progression-free survival, but not overall survival, compared with Navelbine alone in the treatment of recurrent breast cancer. It is not clear whether sequential treatment (one type of chemotherapy followed by another versus administration of both at the same time) would be beneficial to these patients.

Thus, there is phase III evidence for this combination. I consider it no longer investigational and to my knowledge no clinical trials with it are currently ongoing.

Martin M, Ruiz A, Munoz M, et al. Gemcitabine plus vinorelbine versus vinorelbine monotherapy in patients with metastatic breast cancer previously treated with anthracyclines and taxanes: final results of the V. Heinemann et al, Treatment options for patients with pretreated metastatic breast cancer
The Lancet Oncology, Volume 8, Issue 3, Pages 187-189, 2007

Andrew D. Seidman The Evolving Role of Gemcitabine in the Management of Breast Cancer
Oncology Vol. 60, No. 3, 2001

Ermelinda De Maio at al, Vinorelbine plus 3-weekly trastuzumab in metastatic breast cancer: a single-centre phase 2 trial
BMC Cancer 2007, 7:50

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