TY - JOUR
T1 - Gemcitabine, epirubicin, and paclitaxel combinations in advanced breast cancer
AU - Conte, Pier Franco
AU - Salvadori, Barbara
AU - Donati, Sara
AU - Landucci, Elisabetta
AU - Gennari, Alessandra
N1 - Funding Information:
Investigation of combination therapy strategies has included studies of anthracycline/taxane combinations. Early phase studies of anthracycline/ paclitaxel combinations in advanced breast cancer have reported overall response rates of 83% to 94%, including complete response rates of up to 41%.5-7 In an Eastern Cooperative Oncology Group randomized phase III trial (E1193) of first- From tfu Divisione di Oncologia Media, Dipartimento di On-co&a, Ospedde Santa Chicma, Piss, Italy. Dr Come has sewed as a speaker for and has received research grant support from Eli Lilly. Address reprintre quesw to Pier Frunco Conte, MD, Medical Oncology, St Chiara Hospital, Via Roma 67, 56100 Piss, Italy. Copyright 0 2001 by W.B. Saunders Company 0093s7754/01/2802-0704$35.00/O doi:lO. J053/sonc.2001.24367
PY - 2001
Y1 - 2001
N2 - Strategies to improve outcome in metastatic breast cancer include the first-line use of combinations of optimal doses of active agents, with the goal being to improve complete response rates and thus long-term survival. Although prior studies of anthracycline/taxane combinations generally have shown improved response rates and progression-free survival in comparison with single-agent regimens or anthracycline/cyclophosphamide-containing combinations, the data have not consistently demonstrated improved overall survival; indeed, they have yielded generally disappointing complete response rates. We evaluated the combination of gemcitabine (Gemzar; Eli Lilly and Company, Indianapolis, IN), epirubicin, and paclitaxel (GET) based on the hypothesis that epirubicin/paclitaxel is best suited for achieving delivery of optimal doses, and the addition of gemcitabine (which exhibits good single-agent activity with a favorable toxicity profile) will increase activity. In a phase II trial of 36 patients, the GET regimen produced reasonable toxicity and was associated with a 92% response rate, including complete responses in 31% of patients. The overall response rate increased to 97%, including complete responses in 41% of patients, with high-dose consolidation chemotherapy in 25 patients. A trial comparing GET with epirubicin/paclitaxel as first-line treatment in more than 600 patients with metastatic breast cancer has been initiated, with survival as the primary end point. Another large-scale trial is being planned to compare the GET regimen with an anthracycline/cyclophosphamide/paclitaxel combination in patients with early stage high-risk breast cancer.
AB - Strategies to improve outcome in metastatic breast cancer include the first-line use of combinations of optimal doses of active agents, with the goal being to improve complete response rates and thus long-term survival. Although prior studies of anthracycline/taxane combinations generally have shown improved response rates and progression-free survival in comparison with single-agent regimens or anthracycline/cyclophosphamide-containing combinations, the data have not consistently demonstrated improved overall survival; indeed, they have yielded generally disappointing complete response rates. We evaluated the combination of gemcitabine (Gemzar; Eli Lilly and Company, Indianapolis, IN), epirubicin, and paclitaxel (GET) based on the hypothesis that epirubicin/paclitaxel is best suited for achieving delivery of optimal doses, and the addition of gemcitabine (which exhibits good single-agent activity with a favorable toxicity profile) will increase activity. In a phase II trial of 36 patients, the GET regimen produced reasonable toxicity and was associated with a 92% response rate, including complete responses in 31% of patients. The overall response rate increased to 97%, including complete responses in 41% of patients, with high-dose consolidation chemotherapy in 25 patients. A trial comparing GET with epirubicin/paclitaxel as first-line treatment in more than 600 patients with metastatic breast cancer has been initiated, with survival as the primary end point. Another large-scale trial is being planned to compare the GET regimen with an anthracycline/cyclophosphamide/paclitaxel combination in patients with early stage high-risk breast cancer.
UR - http://www.scopus.com/inward/record.url?scp=0035015879&partnerID=8YFLogxK
U2 - 10.1053/sonc.2001.24367
DO - 10.1053/sonc.2001.24367
M3 - Review article
SN - 0093-7754
VL - 28
SP - 15
EP - 17
JO - Seminars in Oncology
JF - Seminars in Oncology
IS - 2 SUPPL. 7
ER -