ADVANCED BREAST-CANCER - INVESTIGATIONAL ROLE OF GEMCITABINE

There have been many recent advances in the treatment of advanced brea st cancer including the introduction of novel drugs and the developmen t of high-dose chemotherapy with peripheral blood stem cell transplant ation (PBSCT). These innovations may offer significant hope for improv ement in the treatment of breast cancer in the near future. Gemcitabin e is a nucleoside analogue with significant antitumour activity in man y human solid tumours. Conflicting results have been observed from stu dies evaluating gemcitabine in advanced breast cancer. Efficacy data f or single-agent gemcitabine range from 25 to 46% depending on starting dose and whether patients have previously received chemotherapy for m etastatic disease (as well as adjuvant use). Gemcitabine is extremely well tolerated, even in heavily pre-treated patients, and is easy to a dminister on an outpatient basis to both chemo-naive and previously tr eated patients. The most common toxicity is mild myelosuppression. Gem citabine causes minimal nausea and vomiting, and significant hair loss is extremely uncommon. Combination chemotherapy studies with anthracy clines are underway and significant activity has been observed in comb ination with both doxorubicin and epirubicin. In view of its modest to xicity profile, and its novel mechanism of action, gemcitabine warrant s further evaluation in breast cancer patients, both as a single agent and in combination chemotherapy schedules. (C) 1997 Elsevier Science Ltd.