Management of metastatic breast cancer (MBC) is difficult and overall response rates (ORR) resulting from anthracycline and taxane-based regimens remain modest. The antimetabolite drug gemcitabine has been shown to have high activity when used as first-line treatment of MBC, particularly when incorporated into combined therapy regimens. Gemcitabine-containing regimens have also been used successfully as salvage therapy in women with anthracycline or taxane-pretreated MBC. Phase II clinical studies have demonstrated high ORR with gemcitabine-docetaxel (ORR: 36-65.5%) and gemcitabine-paclitaxel (ORR: 40-68%) combination regimens. A highly favourable risk-benefit ratio has also been reported for gemcitabine-containing triplets such as gemcitabine-paclitaxel-epirubicin (ORR: 92%) and gemcitabine-paclitaxel-doxorubicin (ORR: 80.4%). Gemcitabine-containing regimens have a favourable toxicity profile with few serious toxic events reported. An important step forward in the evaluation of novel chemotherapeutic regimes for MBC is establishing a correlation between disease markers and response to therapy. Preliminary data suggest that there is a close relationship between HER2 extracellular domain levels (>30 ng/ml) and treatment outcome. HER2-positive patients had a lower ORR to gemcitabine-paclitaxel chemotherapy than women who were HER2-negative. Further studies to establish a link between other breast cancer markers and predicted response to treatment are warranted.

中文翻译：

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吉西他滨-紫杉烷治疗转移性乳腺癌的经验。

转移性乳腺癌（MBC）的管理很困难，基于蒽环类和紫杉烷类疗法的总体缓解率（ORR）仍然很低。当用作MBC的一线治疗药物时，抗代谢药物吉西他滨已显示出高活性，尤其是当纳入联合治疗方案时。含吉西他滨的方案也已成功地用于蒽环类或紫杉烷预处理的MBC的妇女中。II期临床研究表明吉西他滨-多西他赛（ORR：36-65.5％）和吉西他滨-紫杉醇（ORR：40-68％）联合治疗方案具有较高的ORR。对于含吉西他滨的三联体，如吉西他滨-紫杉醇-厄比霉素（ORR：92％）和吉西他滨-紫杉醇-阿霉素（ORR：80.4％），也已经报道了高度有利的风险收益率。含吉西他滨的方案具有良好的毒性，报道的严重毒性事件很少。评估MBC新型化学治疗方案的重要一步是在疾病标志物与治疗反应之间建立相关性。初步数据表明，HER2细胞外结构域水平（> 30 ng / ml）与治疗结果之间存在密切关系。与HER2阴性的女性相比，HER2阳性的患者接受吉西他滨-紫杉醇化疗的ORR较低。有必要进行进一步的研究以建立其他乳腺癌标志物和预期的治疗反应之间的联系。评估MBC新型化学治疗方案的重要一步是在疾病标志物与治疗反应之间建立相关性。初步数据表明，HER2细胞外结构域水平（> 30 ng / ml）与治疗结果之间存在密切关系。与HER2阴性的女性相比，HER2阳性的患者接受吉西他滨-紫杉醇化疗的ORR较低。有必要进行进一步的研究以建立其他乳腺癌标志物和预期的治疗反应之间的联系。评估MBC新型化学治疗方案的重要一步是在疾病标志物与治疗反应之间建立相关性。初步数据表明，HER2细胞外结构域水平（> 30 ng / ml）与治疗结果之间存在密切关系。与HER2阴性的女性相比，HER2阳性的患者接受吉西他滨-紫杉醇化疗的ORR较低。有必要进行进一步的研究以建立其他乳腺癌标志物和预期的治疗反应之间的联系。