Clinical Research Of Vinrelbine-based Combinnation Or Gemcitabine-based Combination Chemotherapy In The Treatment Of Refractory Breast Cancer

Objective: To evaluate the efficacy and safety of vinorelbine-basedcombination or gemcitabine-based combination chemotherapy in the treatmentof metastatic breast cancer after failure of first-line or subsequent linestreatment.Methods: From January2007to December2011,105patients withmetastatic breast cancer after failure of anthracyclines and/or taxane as first-lineor subsequent lines treatment were treated with vinorelbine-basedcombination(including vinorelbine plus Capecitabine, vinorelbine plusCisplatin, vinorelbine plus carboplatin) or gemcitabine-basedcombination(including gemcitabine plus Cisplatin, gemcitabine plusCapecitabine, gemcitabine plus carboplatin) chemotherapy. Drug dosage:vinorelbine25mg/m2/d IV infusion,day1and8every3weeks; Capecitabine 2500mg/m~2/d, orally twice daily for14days followed by a7-day rest periodevery3weeks; cisplatin (DDP)80mg/m~2IV infusion,divided3parts for day1to3every3weeks; carboplatin (CBP)300mg/m~2/d IV infusion, day1every3weeks; gemcitabine1000mg/m~2/d IV infusion, day1and8every3weeks.Toevaluat the efficacy of chemotherapy each1-2cycles.Results: All of105cases can be evaluated. The outcomes ofvinorelbine-based combination chemotherapy included: complete remission(n=2,2.9%), partial remission (n=27,39.7%), stability (n=23,33.8%), diseaseprogression (n=16,23.5%), and the total response rate (RR=CR+PR) was42.6%.The outcomes of gemcitabine-based combination chemotherapy included:complete remission (n=1,2.7%), partial remission (n=13,35.1%), stability(n=14,37.8%), disease progression (n=9,24.3%), and the total response rate(RR=CR+PR) was37.8%. There was no statistical difference in efficacybetween vinorelbine-based combination and gemcitabine-based combinationchemotherapy. The efficacy of each subgroup in vinorelbine-based combinationchemotherapy was no statistical difference, the same was gemcitabine-basedcombination chemotherapy. There was no chemotherapy-related deaths.Themain adverse reactions were myelosuppression and gastrointestinal reactions.Incidence of III-IV degree adverse reactions was as follows(vinorelbine-basedVS gemcitabine-based): leukopenia26.4%VS29.4%, neutropenia33.8%VS35.3%, thrombocytopenia5.9%VS10.8%, nausea or vomiting4.4%VS8.1%. There was no statistical difference in adverse reactions between vinorelbine-based combination and gemcitabine-based combinationchemotherapy.Conclusion: Vinorelbine-based combination and gemcitabine-basedcombination chemotherapy have good efficacy in the treatment of metastaticbreast cancer after failure of anthracyclines and/or taxane as first-line orsubsequent lines treatment. Their adverse reactions are similar andtolerated.They can be alternative treatment options for metastatic breast cancer.