Gemcitabine-based chemotherapy as a viable option for treatment of advanced breast cancer patients: a meta-analysis and literature review

Abstract

This meta-analysis was designed to compare the efficacy and safety of gemcitabine-based regimens for the treatment advanced breast cancer (ABC). Altogether 15 studies involving 8195 ABC patients were retrieved for analysis. Compared with non-gemcitabine-based chemotherapies, patients receiving gemcitabine-based therapy exhibited better overall survival (OS), progression free survival (PFS), and objective response rate (ORR) (HR = 1.12, 95% CI 1.05 to 1.19; HR = 1.16, 95% CI 1.03 to 1.30; HR = 1.14, 95% CI 1.04 to 1.24). Grade 3/4 hematologic toxicity was significantly high but manageable in gemcitabine-based groups. Subgroup analysis revealed that patients with first-line gemcitabine-based chemotherapy had better OS (HR = 1.19, 95% CI 1.07 to 1.32), PFS (HR = 1.17, 95% CI 1.08 to 1.27), and ORR (RR = 1.16, 95% CI 1.02 to 1.32). In addition, additional gemcitabine chemotherapy also showed better OS (HR = 1.17, 95% CI 1.06 to 1.30), PFS (HR = 1.20, 95% CI 1.11 to 1.30) and ORR (RR = 1.23, 95% CI 1.06 to 1.42) than gemcitabine replacement therapy. Furthermore, patients receiving gemcitabine-taxanes-based regimens had better OS (HR = 1.17, 95% CI 1.06 to 1.28), PFS (HR = 1.12, 95% CI 1.04 to 1.20) and ORR (RR = 1.17, 95% CI 1.01 to 1.35) than patients with non-gemcitabine-taxanes-based chemotherapy. These findings indicate that gemcitabine combination regimens could serve as a promising regimen for ABC patients, though increased hematologic toxicity should be considered with caution.

Retracted Article: Gemcitabine aggravates miR-199a-5p-mediated breast cancer cell apoptosis by promoting VEGFA downregulation via inactivating the AKT signaling pathway

“…25 This agent has proven antitumor activity and tolerability in various malignancies, including breast cancer. 26 Gemcitabine monotherapy has led to response rates of 37% in the rstline setting, 26% in the second-line setting, and 18% in the third-line setting. 25 Although Gemcitabine has been studied extensively in the phase II setting, it appears to have no particular advantage over existing chemotherapeutic agents in the third-line or greater setting.…”

Circular RNA circRNF20 promotes breast cancer tumorigenesis and Warburg effect through miR-487a/HIF-1α/HK2

“…Besides factors above, epigenetic mutations are also important factors in the tumorigenesis of BC 6 . Therefore, it is critical to identify the molecular mechanisms involved in the proliferation and progression genesis in BC [7][8][9] . Moreover, more valuable coping strategies and precise targeting therapies are pressing challenges with significant clinical implications.…”

Toxicity and Pharmacogenomic Biomarkers in Breast Cancer Chemotherapy

“…Controversial outcomes were retrieved from studies that evaluated the benefit of adding gemcitabine to treatment regimens or using it as a single agent in advanced BC. One recent metanalysis indicated that using gemcitabine in combination therapies demonstrated favorable outcomes in advanced, however, with considerable associated hematological toxicity (Xie et al, 2018).…”