Outcomes of Palliative Weekly Low-Dose Gemcitabine-Cisplatin Chemotherapy in Anthracycline- and Taxane- Pretreated Metastatic Breast Cancer Patients

Kim, Jung Sun; Park, In Hae; Lee, Keun Seok; Ro, Jungsil

doi:10.4048/jbc.2014.17.4.339

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…Moreover, gemcitabine can be used with bisphosphonate in the treatment of bone metastases of breast cancer [ 152 ]. Furthermore, low dose of gemcitabine plus cisplatin combination weekly showed efficacy and safety in the treatment of brain metastasis of breast cancer [ 153 ] and treatment of strongly pretreated MBC patients resistant to taxanes and anthracyclines treatments [ 154 , 155 ].…”

Section: Treatments Of Metastatic Breast Cancermentioning

confidence: 99%

Metastatic and triple-negative breast cancer: challenges and treatment options

Al-Mahmood

Sapiezynski

Garbuzenko

et al. 2018

Drug Deliv. and Transl. Res.

402

258

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The major current conventional types of metastatic breast cancer (MBC) treatments include surgery, radiation, hormonal therapy, chemotherapy, or immunotherapy. Introducing biological drugs, targeted treatment and gene therapy can potentially reduce the mortality and improve the quality of life in patients with MBC. However, combination of several types of treatment is usually recommended. Triple negative breast cancer (TNBC) accounts for 10–20% of all cases of breast carcinoma and is characterized by the low expression of progesterone receptor (PR), estrogen receptor (ER), and human epidermal growth factor receptor 2 (HER2). Consequently, convenient treatments used for MBC that target these receptors are not effective for TNBC which therefore requires special treatment approaches. This review discusses the occurrence of MBC, the prognosis and predictive biomarkers of MBC, and focuses on the novel advanced tactics for treatment of MBC and TNBC. Nanotechnology-based combinatorial approach for the suppression of EGFR by siRNA and gifitinib is described.

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Section: Treatments Of Metastatic Breast Cancermentioning

confidence: 99%

Metastatic and triple-negative breast cancer: challenges and treatment options

Al-Mahmood

Sapiezynski

Garbuzenko

et al. 2018

Drug Deliv. and Transl. Res.

402

258

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“…The RD was determined to be gemcitabine 800 mg/m 2 iv and cisplatin 30 mg/m 2 iv on days 1 and 8 every 3 weeks and everolimus 5 mg daily po. We assumed that the doses of the two cytotoxic drugs were acceptable as a combination therapy based on our previous report 5 . Although the dose of everolimus was lower than that used in monotherapy, it did not necessarily mean that the lower dose of everolimus lacked efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…In a phase II study of patients with metastatic TNBC, the combination of carboplatin and gemcitabine showed an overall response rate of 32% 4 . According to our previous data, even a low dose of gemcitabine and cisplatin had clinical efficacy with overall survival of 7.6 months in heavily pretreated metastatic TNBC patients 5 .…”

Section: Introductionmentioning

confidence: 88%

Phase I/II clinical trial of everolimus combined with gemcitabine/cisplatin for metastatic triple-negative breast cancer

Park¹,

Kong²,

Kwon³

et al. 2018

J. Cancer

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Background: The PI3K/AKT/mTOR pathway is an important oncogenic driver in triple-negative breast cancer (TNBC). This study investigated the clinical efficacy and safety of the combination of gemcitabine and cisplatin with everolimus (GPE) in patients with metastatic TNBC.Methods: In phase I, we assessed the maximum tolerated dose (MTD) of GPE in metastatic TNBC patients. Then, using a seamless design, we conducted a randomized phase II trial to compare GPE to GP in terms of progression-free survival (PFS) and toxicity. In addition, we investigated the mutational status of PIK3CA (E542K, E545K, H1047R) in tumor tissues (n=14) and cell-free DNA (cfDNA) from blood samples (n=23) using droplet digital PCR.Results: In phase I (n=9), we found that the MTD of GPE was gemcitabine 800 mg/m2 and cisplatin 30 mg/m2 on days 1 and 8 every 3 weeks along with everolimus 5 mg daily. Phase II was terminated early after 14 patients had been enrolled because of slow recruitment and concerns about efficacy. Results of the combined analysis of phases I and II showed the objective response rate (ORR) of GPE (n=16) was 31.3% and the median PFS was 5.5 months (95% CI, 3.5-7.5). Stomatitis and hematologic toxicities were observed most frequently in the GPE arm. PIK3CA mutations were identified in 8 (57.1%) tumor samples and 17 (73.9%) cfDNA samples; there was no significant association between PIK3CA mutation status and response to GPE treatment.Conclusions: Although the majority of patients with metastatic TNBC demonstrated PIK3CA mutations in cfDNA, the addition of everolimus to gemcitabine/cisplatin did not have a synergistic effect in these patients. Further studies are needed to determine the most effective way to target the PI3K/AKT/mTOR pathway in TNBC patients.

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“…In the metastatic setting, several studies have demonstrated the efficacy of cisplatin plus gemcitabine combination therapy in TNBC [17, 18].…”

Section: Introductionmentioning

confidence: 99%

Post-Neoadjuvant Gemcitabine and Cisplatin with Regional Hyperthermia for Patients with Triple-Negative Breast Cancer and Non-pCR after Neoadjuvant Chemotherapy: A Single-Institute Experience

Stoetzer¹,

Gioia

Issels

et al. 2020

Breast Care

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Background: Patients with triple-negative primary breast cancer (TNBC) who have residual invasive carcinoma after neoadjuvant chemotherapy have poor prognosis. Proven adjuvant approaches to reduce the risk of recurrence and improve outcome in patients with non-pathological complete response (non-pCR) are limited. Methods: From our institutional registry, a consecutive case series of patients with operable, unilateral, primary invasive noninflammatory early TNBC of stage I-IIIB and pathologically verified residual cancer cells (no pathological complete response) after neoadjuvant chemotherapy underwent adjuvant treatment with gemcitabine plus cisplatin combined with regional hyperthermia. For quality assurance, we analyzed feasibility, efficacy, and toxicity of all treated patients. Outcome was evaluated for the entire group of patients as well as for the subgroups of patients with or without lymph node involvement at baseline (cN0/ cN+). Results: From August 2012 to January 2019, we offered this treatment to 53 patients at our center as part of routine care. The median follow-up was 38 months. The majority of patients (64.2%) had cT2 tumors at baseline. Twenty-four patients (45%) were clinically node positive as evaluated by sonography. Thirty-nine patients (74%) had grade 3, and 14 patients (26%) had grade 2 tumors. Forty-one patients (76%) showed a regression grade 1 according to Sinn. Patients received a median of six treatment cycles of gemcitabine and cisplatin (range 1–6) combined with 12 applications of regional hyperthermia (median 12, range 2–12). Disease-free survival (DFS) at 3 years was 57.5%. In patients with no lymph node involvement at baseline (cN0), DFS at 3 years was significantly higher than in initially node-positive (cN+) patients (80 vs. 31%; p = 0.001). Overall survival (OS) at 3 years was 81.6%. In patients with no lymph node involvement at baseline (cN0), OS at 3 years was significantly higher than in node-positive (cN+) patients (93 vs. 70.4%; p = 0.02). Overall, grade 3/4 toxicities were leukopenia (38%), thrombocytopenia (4%), and anemia (4%). Conclusion: After standard neoadjuvant chemotherapy containing anthracycline plus cyclophosphamide followed by taxanes, addition of adjuvant gemcitabine plus cisplatin in combination with regional hyperthermia was safe and effective in TNBC patients with non-pCR.

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Outcomes of Palliative Weekly Low-Dose Gemcitabine-Cisplatin Chemotherapy in Anthracycline- and Taxane- Pretreated Metastatic Breast Cancer Patients

Cited by 6 publications

References 21 publications

Metastatic and triple-negative breast cancer: challenges and treatment options

Metastatic and triple-negative breast cancer: challenges and treatment options

Phase I/II clinical trial of everolimus combined with gemcitabine/cisplatin for metastatic triple-negative breast cancer

Post-Neoadjuvant Gemcitabine and Cisplatin with Regional Hyperthermia for Patients with Triple-Negative Breast Cancer and Non-pCR after Neoadjuvant Chemotherapy: A Single-Institute Experience

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