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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.

Breast cancer claims the lives of approximately 40,000 women annually in the United States. Recurrent breast cancer refers to cancer that has progressed or returned following prior therapy.

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.

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.

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  • 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.
  • Severe side effects were similar between the two treatment groups; however, patients treated with the addition of Gemzar had increased risk of low levels of immune cells and low levels of immune cells accompanied by fever.

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. Women with recurrent breast cancer may wish to speak with their physician regarding their individual risks and benefits of each treatment option.

Reference: 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 Phase III Spanish Breast Cancer Research Group (GEICAM) trial. Lancet Oncology [early online publication]. February 16, 2007. DOI: 10.1016/S1470-2045(07)70041-4.

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