Gemcitabine plus docetaxel: a new treatment option for anthracycline pretreated metastatic breast cancer patients?

Antimetabolite-taxane combinations have been shown to be effective chemotherapy in patients with metastatic breast cancer (MBC). A multicentre phase III trial comparing gemcitabine-docetaxel with capecitabine-docetaxel in women with anthracycline pretreated MBC was carried out in several European countries. Its results were presented recently [1]. One-hundred and fifty-three patients were randomly assigned to receive docetaxel (75 mg/m2, day 1) plus gemcitabine (1000 mg/m2, days 1, 8) and 152 received docteaxel plus capecitabine (1250 mg/m2, bid days 1-14) every 3 weeks until disease progression. No difference in efficacy of the two treatment regimens was observed in terms of progression-free survival (35 weeks in both treatment arms), overall response rate (32% vs. 32%), time to treatment failure (19 vs. 18 weeks, respectively), or response duration (36 vs. 42 weeks). Drug-related toxicity, particularly hand-foot syndrome, mucositis and diarrhoea, was more frequent with capecitabine-docetaxel and there was a higher incidence of drug-related treatment withdrawals with this combination. Gemcitabine-docetaxel appeared to have a more favourable risk-benefit profile than capecitabine-docetaxel, and is an important new treatment option for women with anthracycline-pretreated MBC.