Efficacy and Safety of Vinorelbine Plus Cisplatin vs. Gemcitabine Plus Cisplatin for Treatment of Metastatic Triple-Negative Breast Cancer After Failure with Anthracyclines and Taxanes

Abstract

BackgroundThis study aimed to compare the efficacy and safety of vinorelbine plus cisplatin (NP regimen) vs. gemcitabine plus cisplatin (GP regimen) for treatment of metastatic TNBC after failure with anthracyclines and taxanes.Material/MethodsA total of 48 patients with metastatic TNBC that failed in anthracyclines and taxanes treatment were enrolled and randomly grouped. Patients in the NP group (n=22) were given 25 mg/m2 vinorelbine on days 1 and 8 and 25 mg/m2 cisplatin on days 2–4 of each 21-day cycle, while subjects in the GP group (n=26) were administered 1000 mg/m2 gemcitabine on days 1 and 8 and 25 mg/m2 cisplatin on days 2–4 of each 21-day cycle. The treatment response and adverse events were compared between the 2 groups every 2 cycles.ResultsThe ORR, DCR, and median TTP were 45.5%, 77.3%, and 5 months in the NP group, and 46.2%, 80.8%, and 5.2 months in the GP group, and no significant differences were observed in ORR, DCR, and median TTP between the 2 groups (P>0.05). The major adverse events included grade I–II bone marrow inhibition, gastrointestinal reactions, and phlebitis, and a lower incidence of thrombocytopenia and rash and a higher incidence of phlebitis was found in the NP group than in the GP group (P<0.05).ConclusionsEither NP or GP regimen is active and tolerated in treatment of metastatic TNBC with anthracyclines and/or taxanes resistance, which may be used as a salvage treatment for metastatic TNBC.

Mechanisms, Diagnosis and Treatment of Bone Metastases

“…For prostate cancer patients, taxanes (docetaxel and cabazitaxel), which are mitotic inhibitors, provide the only systemic treatment option [ 220 , 221 , 222 ]. In cases involving breast cancer patients with bone metastases, the chemotherapeutic armamentarium contains several compounds including anthracyclins (inhibitors of DNA synthesis and RNA synthesis) [ 223 ], vinorelbine (microtubule disruptor) [ 224 ] and capecitabine (thymidylate synthase inhibitor) [ 225 ] combined with surgical resection of the primary and metastatic tumors. In the absence of any proven alternatives, chemotherapeutic treatment of osteosarcoma patients with bone metastases still follows the same approach with three agents (methotrexate, cisplatin and doxorubicin) as the treatment of the primary tumor [ 226 ].…”

Combined use of apatinib mesylate and vinorelbine versus vinorelbine alone in recurrent or metastatic triple-negative breast cancer: study protocol for a randomized controlled clinical trial

“…While previous cohort studies [13,20,21], retrospective observations [22][23][24][25], and case reports [26,27] have addressed the clinical treatment of TNBC with apatinib or vinorelbine (Table 1), there have been no reports of a randomized, controlled clinical trial in North China. As BRCA-positive patients would have poor responses to the therapeutic methods designed in this study, BRCAnegative female patients with locally recurrent or metastatic TNBC, who have previously received anthracycline and taxane treatment, will be the target population in this trial.…”

Combined use of apatinib mesylate and vinorelbine versus vinorelbine alone in recurrent or metastatic triple-negative breast cancer: study protocol for a randomized controlled clinical trial

“…While previous cohort studies [20][21][22], retrospective observations [23][24][25][26], and case reports [27,28] have addressed the clinical treatment of TNBC with apatinib or vinorelbine (Table 1), a randomized controlled clinical trial has not been reported in North China. As BRCA-positive patients would have poor responses to the therapeutic methods designed in this study, BRCA-negative female patients with locally recurrent or metastatic TNBC, who have previously received anthracycline and taxane treatment, will be the target population in this trial.…”