Effect of Gemcitabine Combined with Docetaxel in The Treatment of Advanced Breast Cancer: Report of 48 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

Department of Breast Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China;

Corresponding?author：

Keywords：

Advanced breast cancer; Gemcitabine; Docetaxel; Chemotherapy; Effect

DOI：

10.7507/1007-9424.20160271

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Objective To expolre the effect and safety of gemcitabine combined with docetaxel in the treatment of advanced breast cancer. Methods Forty-eight breast cancer patients who got treatment by gemcitabine combined with docetaxel from March 2013 to March 2014 were prospectively enrolled in this study. Results Of all the 48 patients, the completely responded (CR) rate was 16.7%(8/48), partial responded (PR) rate was 35.4%(17/48), stable disease (SD) rate was 33.3% (16/48), progressive disease (PD) rate was 14.6% (7/48), and the response rate was 52.1% (25/48), the clinical benefit rate was 85.4% (41/48). The response rates of hormone receptor (HR)-positive group, human epidermal growth factor receptor 2 (HER-2)-positive group, and Basal-like group were 43.5% (10/23), 54.5% (6/11), and 64.3% (9/14) respectively, the clinical benefit rates of HR-positive group, HER-2-positive group, and Basal-like group were 82.6% (19/23), 81.8% (9/11), and 92.9% (13/14) respectively. There was no significant difference among the 3 groups in the effect, response rate, and clinical benefit rate (P=0.293, P=0.462, P=0.663). All patients suffered from varying degrees of toxicities during chemotherapy, including leukopenia, neutropenia, decreased hemoglobin, thrombocytopenia, rash, nausea, vomiting, hair loss, diarrhea, fatigue, and elevated alanine aminotransferase, wherein leukopenia (27.1%, 13/48), neutropenia (22.9%, 11/48), thrombocytopenia (4.2%, 2/48), and fatigue (10.4%, 5/48) were included inⅢ-Ⅳ degree of adverse reactions. In addition, all of 48 patients were followed-up for 1-19 months, with a median follow-up time of 12 months. During follow-up period, 6 patients died, and the overall survival rate was 87.5% (42/48). There was no significant difference among the 3 groups in overall survival and progression free survival (P > 0.050). Conclusion Gemcitabine combined with docetaxel may be an effective therapy in treatment of advanced breast cancer.

Citation： HE Chun-mei, HE Hong-zhou, WU Bin. Effect of Gemcitabine Combined with Docetaxel in The Treatment of Advanced Breast Cancer: Report of 48 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(9): 1044-1049. doi: 10.7507/1007-9424.20160271 Copy

1.	中國女醫師協會臨床腫瘤學專業委員會, 中國抗癌協會乳腺癌專業委員會.中國進展期乳腺癌共識指南(CABC 2015).癌癥進展, 2015, 13(3):223-245.
2.	劉蔭華, 劉倩.客觀解讀RECIST(修訂版)的臨床評價意義.中國實用外科雜志, 2010, 30(1):31-33.
3.	文芳, 翁潔, 羅盤.吉西他濱聯合卡培他濱二線治療晚期乳腺癌的療效評價.中國腫瘤外科雜志, 2015, 7(3):184-185, 188.
4.	鄭瑩, 吳春曉, 張敏璐.乳腺癌在中國的流行狀況和疾病特征.中國癌癥雜志, 2013, 23(8):561-569.
5.	Borson R, Harker G, Reeves J, et al. Phase Ⅱ study of gemcitabine and bevacizumab as first-line treatment in taxane-pretreated, HER2-negative, locally recurrent or metastatic breast cancer. Clin Breast Cancer, 2012, 12(5):322-330.
6.	Mangini NS, Wesolowski R, Ramaswamy B, et al. Palbociclib:a novel cyclin-dependent kinase inhibitor for hormone receptor-positive advanced breast cancer. Ann Pharmacother, 2015, 49(11):1252-1260.
7.	Lawson DA, Bhakta NR, Kessenbrock K, et al. Single-cell analysis reveals a stem-cell program in human metastatic breast cancer cells. Nature, 2015, 526(7571):131-135.
8.	Golubnitschaja O, Yeghiazaryan K, Costigliola V, et al. Risk assessment, disease prevention and personalised treatments in breast cancer:is clinically qualified integrative approach in the horizon. EPMA J, 2013, 4(1):6.
9.	徐兵河.晚期乳腺癌的治療原則與策略.中國醫藥導報, 2010, 7(6):6-8.
10.	張志強, 江澤飛, 宋三泰.吉西他濱在乳腺癌化療中的臨床應用.國外醫學:腫瘤學分冊, 2003, 30(2):132-135.
11.	中國抗癌協會乳腺癌專業委員會.中國抗癌協會乳腺癌診治指南與規范(2015版).中國癌癥雜志, 2015, 25(9):692-754.
12.	Seidman AD, Chan S, Wang J, et al. A pooled analysis of gemcitabine plus docetaxel versus capecitabine plus docetaxel in metastatic breast cancer. Oncologist, 2014, 19(5):443-452.
13.	Garcia AA, Yessaian A, Pham H, et al. PhaseⅡ study of gemcitabine and docetaxel in recurrent platinum resistant ovarian cancer. Cancer Invest, 2012, 30(4):295-299.
14.	張丹華, 周恩相.紫杉醇注射液、紫杉醇脂質體以及多西他賽治療乳腺癌的療效及安全性.中國癌癥雜志, 2013, 23(12):1014-1016.
15.	Ghersi D, Willson ML, Chan MM, et al. Taxane-containing regimens for metastatic breast cancer. Cochrane Database Syst Rev, 2015, (6):CD003366.
16.	馬焱, 孟祥穎, 吳世凱, 等.多西他賽解救治療紫杉醇耐藥的轉移性乳腺癌的臨床研究.癌癥進展, 2012, 10(3):251-256.
17.	向其德, 覃事鵬, 譚力, 等.吉西他濱聯合多西他賽治療蒽環類耐藥性晚期乳腺癌的臨床觀察.現代醫藥衛生, 2013, 29(20):3067-3068.
18.	Ciruelos EM, Cortés J, Cortés-Funes H, et al. Gemcitabine and capecitabine in previously anthracycline-treated metastatic breast cancer:a multicenter phaseⅡ study (SOLTI 0301 trial). Ann Oncol, 2010, 21(7):1442-1447.
19.	Karachaliou N, Ziras N, Syrigos K, et al. A multicenter phaseⅡ trial of docetaxel and capecitabine as salvage treatment in anthracyclineand taxane-pretreated patients with metastatic breast cancer. Cancer Chemother Pharmacol, 2012, 70(1):169-176.
20.	張慎鋒, 田濤, 王文朋, 等.多西他賽聯合吉西他濱治療復發轉移性乳腺癌臨床療效及預后影響因素.國際腫瘤學雜志, 2013, 40(8):634-638.
21.	謝劍明, 謝亞琳, 劉斐燁, 等.多西他賽聯合吉西他濱治療轉移性乳腺癌效果觀察.中國熱帶醫學, 2010, 10(10):1265-1266.
22.	Yi SY, Ahn JS, Uhm JE, et al. Favorable response to doxorubicin combination chemotherapy does not yield good clinical outcome in patients with metastatic breast cancer with triple-negative phenotype. BMC Cancer, 2010, 10(1):527-534.
23.	Liedtke C, Broglio K, Moulder S, et al. Prognostic impact of discordance between triple-receptor measurements in primary and recurrent breast cancer. Ann Oncol, 2009, 20(12):1953-1958.
24.	Amir E, Miller N, Geddie W, et al. Prospective study evaluating the impact of tissue confirmation of metastatic disease in patients with breast cancer. J Clin Oncol, 2012, 30(6):587-592.
25.	駱梅青, 李錫清.不同分子亞型的晚期乳腺癌化療療效觀察.現代腫瘤醫學, 2010, 18(5):914-917.

1. 中國女醫師協會臨床腫瘤學專業委員會, 中國抗癌協會乳腺癌專業委員會.中國進展期乳腺癌共識指南(CABC 2015).癌癥進展, 2015, 13(3):223-245.
2. 劉蔭華, 劉倩.客觀解讀RECIST(修訂版)的臨床評價意義.中國實用外科雜志, 2010, 30(1):31-33.
3. 文芳, 翁潔, 羅盤.吉西他濱聯合卡培他濱二線治療晚期乳腺癌的療效評價.中國腫瘤外科雜志, 2015, 7(3):184-185, 188.
4. 鄭瑩, 吳春曉, 張敏璐.乳腺癌在中國的流行狀況和疾病特征.中國癌癥雜志, 2013, 23(8):561-569.
5. Borson R, Harker G, Reeves J, et al. Phase Ⅱ study of gemcitabine and bevacizumab as first-line treatment in taxane-pretreated, HER2-negative, locally recurrent or metastatic breast cancer. Clin Breast Cancer, 2012, 12(5):322-330.
6. Mangini NS, Wesolowski R, Ramaswamy B, et al. Palbociclib:a novel cyclin-dependent kinase inhibitor for hormone receptor-positive advanced breast cancer. Ann Pharmacother, 2015, 49(11):1252-1260.
7. Lawson DA, Bhakta NR, Kessenbrock K, et al. Single-cell analysis reveals a stem-cell program in human metastatic breast cancer cells. Nature, 2015, 526(7571):131-135.
8. Golubnitschaja O, Yeghiazaryan K, Costigliola V, et al. Risk assessment, disease prevention and personalised treatments in breast cancer:is clinically qualified integrative approach in the horizon. EPMA J, 2013, 4(1):6.
9. 徐兵河.晚期乳腺癌的治療原則與策略.中國醫藥導報, 2010, 7(6):6-8.
10. 張志強, 江澤飛, 宋三泰.吉西他濱在乳腺癌化療中的臨床應用.國外醫學:腫瘤學分冊, 2003, 30(2):132-135.
11. 中國抗癌協會乳腺癌專業委員會.中國抗癌協會乳腺癌診治指南與規范(2015版).中國癌癥雜志, 2015, 25(9):692-754.
12. Seidman AD, Chan S, Wang J, et al. A pooled analysis of gemcitabine plus docetaxel versus capecitabine plus docetaxel in metastatic breast cancer. Oncologist, 2014, 19(5):443-452.
13. Garcia AA, Yessaian A, Pham H, et al. PhaseⅡ study of gemcitabine and docetaxel in recurrent platinum resistant ovarian cancer. Cancer Invest, 2012, 30(4):295-299.
14. 張丹華, 周恩相.紫杉醇注射液、紫杉醇脂質體以及多西他賽治療乳腺癌的療效及安全性.中國癌癥雜志, 2013, 23(12):1014-1016.
15. Ghersi D, Willson ML, Chan MM, et al. Taxane-containing regimens for metastatic breast cancer. Cochrane Database Syst Rev, 2015, (6):CD003366.
16. 馬焱, 孟祥穎, 吳世凱, 等.多西他賽解救治療紫杉醇耐藥的轉移性乳腺癌的臨床研究.癌癥進展, 2012, 10(3):251-256.
17. 向其德, 覃事鵬, 譚力, 等.吉西他濱聯合多西他賽治療蒽環類耐藥性晚期乳腺癌的臨床觀察.現代醫藥衛生, 2013, 29(20):3067-3068.
18. Ciruelos EM, Cortés J, Cortés-Funes H, et al. Gemcitabine and capecitabine in previously anthracycline-treated metastatic breast cancer:a multicenter phaseⅡ study (SOLTI 0301 trial). Ann Oncol, 2010, 21(7):1442-1447.
19. Karachaliou N, Ziras N, Syrigos K, et al. A multicenter phaseⅡ trial of docetaxel and capecitabine as salvage treatment in anthracyclineand taxane-pretreated patients with metastatic breast cancer. Cancer Chemother Pharmacol, 2012, 70(1):169-176.
20. 張慎鋒, 田濤, 王文朋, 等.多西他賽聯合吉西他濱治療復發轉移性乳腺癌臨床療效及預后影響因素.國際腫瘤學雜志, 2013, 40(8):634-638.
21. 謝劍明, 謝亞琳, 劉斐燁, 等.多西他賽聯合吉西他濱治療轉移性乳腺癌效果觀察.中國熱帶醫學, 2010, 10(10):1265-1266.
22. Yi SY, Ahn JS, Uhm JE, et al. Favorable response to doxorubicin combination chemotherapy does not yield good clinical outcome in patients with metastatic breast cancer with triple-negative phenotype. BMC Cancer, 2010, 10(1):527-534.
23. Liedtke C, Broglio K, Moulder S, et al. Prognostic impact of discordance between triple-receptor measurements in primary and recurrent breast cancer. Ann Oncol, 2009, 20(12):1953-1958.
24. Amir E, Miller N, Geddie W, et al. Prospective study evaluating the impact of tissue confirmation of metastatic disease in patients with breast cancer. J Clin Oncol, 2012, 30(6):587-592.
25. 駱梅青, 李錫清.不同分子亞型的晚期乳腺癌化療療效觀察.現代腫瘤醫學, 2010, 18(5):914-917.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Gemcitabine Combined with Docetaxel in The Treatment of Advanced Breast Cancer: Report of 48 Cases

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