Abstract
This meta-analysis was designed to compare the efficacy and safety of gemcitabine-based regimens for the treatment advanced breast cancer (ABC). Altogether 15 studies involving 8195 ABC patients were retrieved for analysis. Compared with non-gemcitabine-based chemotherapies, patients receiving gemcitabine-based therapy exhibited better overall survival (OS), progression free survival (PFS), and objective response rate (ORR) (HR = 1.12, 95% CI 1.05 to 1.19; HR = 1.16, 95% CI 1.03 to 1.30; HR = 1.14, 95% CI 1.04 to 1.24). Grade 3/4 hematologic toxicity was significantly high but manageable in gemcitabine-based groups. Subgroup analysis revealed that patients with first-line gemcitabine-based chemotherapy had better OS (HR = 1.19, 95% CI 1.07 to 1.32), PFS (HR = 1.17, 95% CI 1.08 to 1.27), and ORR (RR = 1.16, 95% CI 1.02 to 1.32). In addition, additional gemcitabine chemotherapy also showed better OS (HR = 1.17, 95% CI 1.06 to 1.30), PFS (HR = 1.20, 95% CI 1.11 to 1.30) and ORR (RR = 1.23, 95% CI 1.06 to 1.42) than gemcitabine replacement therapy. Furthermore, patients receiving gemcitabine-taxanes-based regimens had better OS (HR = 1.17, 95% CI 1.06 to 1.28), PFS (HR = 1.12, 95% CI 1.04 to 1.20) and ORR (RR = 1.17, 95% CI 1.01 to 1.35) than patients with non-gemcitabine-taxanes-based chemotherapy. These findings indicate that gemcitabine combination regimens could serve as a promising regimen for ABC patients, though increased hematologic toxicity should be considered with caution.
Highlights
Breast cancer is one of the most prevalent cancers, causing approximately half a million deaths per year worldwide [1]
The study of Park et al [22] was excluded because their patients were randomized to receive a combination of gemcitabine and vinorelbine or gemcitabine until disease progression followed by vinorelbine monotherapy
Taxane/anthracycline-based chemotherapy is the treatment of choice in most cancer centers and countries for the treatment of advanced breast cancer (ABC), and a wide variety of single agents or combination therapies have been investigate for patients previously treated with both a taxane and an anthracycline [38]
Summary
Breast cancer is one of the most prevalent cancers, causing approximately half a million deaths per year worldwide [1]. Among the chemotherapeutic agents currently available for the treatment of ABC, anthracyclines and taxanes are considered the most active and represent widely used treatment options [5, 6]. Chemotherapy regimens containing anthracyclines and/or taxanes are often considered as the standard option for www.impactjournals.com/oncotarget adjuvant treatment of early breast cancer, especially in high-risk women, limiting their use in patients who subsequently develop disease relapse [7, 8]. Many clinical trials with large sample size discovered that combination regimens containing gemcitabine could prolong both overall survival (OS) and PFS without increasing the occurrence of serious adverse events (ADEs) [12, 13]. Researchers used gemcitabine combination regimens as the experimental group, and another totally different chemotherapy regimen as the control group [19]. We focused on gemcitabine-based chemotherapies versus non-gemcitabine-based therapies for the treatment of ABC
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