Gemcitabine plus paclitaxel (GT) versus paclitaxel (T) as first-line treatment for anthracycline pre-treated metastatic breast cancer (MBC): Quality of life (QoL) and pain palliation results from the global phase III study

Moinpour, Carol M.; Wu, Juan; Donaldson, Gary; Liepa, Astra M.; Melemed, Allen S.; O'Shaughnessy, J; Rappold, Erica; Albain, Kathy S.

doi:10.1200/jco.2004.22.14_suppl.621

Cited by 25 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Of these trials, four were phase III randomized clinical studies [5][6][7][8][9][10][11][12][13][14], one was a randomized phase II clinical trial [15], and the remainder were single-arm phase II clinical trials (see tables for references). Thirty-nine of the studies were reported solely in abstract form.…”

Section: Resultsmentioning

confidence: 99%

“…O'Shaughnessy et al, Albain et al, and Moinpour et al [7][8][9][10][11][12] presented at the 2003 and 2004 ASCO meetings two different interim analyses of a randomized phase III trial of paclitaxel versus gemcitabine and paclitaxel in first-line therapy for women with metastatic breast cancer. The first [7][8][9][10] was a planned interim analysis of TTP, PFS, ORR, toxicity, and quality of life.…”

Section: Randomized Trialsmentioning

confidence: 99%

See 1 more Smart Citation

Gemcitabine in the management of metastatic breast cancer: a systematic review

Dent

Messersmith

Trudeau

2007

Breast Cancer Res Treat

View full text Add to dashboard Cite

Available data do not support the acceptance of gemcitabine as a standard therapeutic option in women with metastatic breast cancer in the third-line or greater setting, nor should it be considered as first-line therapy in anthracycline naïve women. Gemcitabine appears to be most effective when administered with a taxane (docetaxel/paclitaxel) in the first- or second-line setting, with gemcitabine/taxane combinations representing a viable alternative to currently accepted taxane combinations such as capecitabine/docetaxel. There is no evidence at this time to support the use of gemcitabine triplets, given the equal efficacy to anthracycline triplets and the added toxicity.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Randomized Trialsmentioning

confidence: 99%

Gemcitabine in the management of metastatic breast cancer: a systematic review

Dent

Messersmith

Trudeau

2007

Breast Cancer Res Treat

View full text Add to dashboard Cite

show abstract

“…Patients receiving docetaxel alone experienced more neutropenic fever, myalgia, and arthralgia compared with patients in the combination group, while patients receiving combination therapy experienced more diarrhea, stomatitis, nausea, vomiting, and hand-foot syndrome [28]. A similar study of paclitaxel with or without gemcitabine in metastatic breast cancer showed superiority for the combination arm and led to the recent approval of gemcitabine in this combination as first-line treatment of metastatic breast cancer [29,30]. A challenge in determining the relative benefits of single-agent treatment versus combination therapy has been that many studies have compared one agent with a combination of agents rather than comparing the same agents administered either in sequence or in combination.…”

Section: Combination Chemotherapymentioning

confidence: 94%

Optimizing the treatment of metastatic breast cancer

Gralow

2005

Breast Cancer Res Treat

View full text Add to dashboard Cite

There is currently no standard care for metastatic breast cancer; consequently, individual patient and tumor characteristics are among several factors considered in treatment decisions. Clinical studies continue to clarify the roles of endocrine therapy, chemotherapy, and biologic therapy, and results have been promising. For patients with hormone receptor-positive disease, several endocrine agents are currently available including selective estrogen receptor (ER) modulators (tamoxifen and toremifene), aromatase inhibitors (anastrozole, exemestane, and letrozole), as well as the selective ER down-regulator, fulvestrant. Effective first- and second-line, single-agent chemotherapeutic treatments include the taxanes, anthracyclines, vinorelbine, capecitabine, and gemcitabine. The benefits of sequential, single-agent versus combination chemotherapy are also being evaluated. Although combination chemotherapy generally results in a greater objective response, it is associated with similar survival and usually greater toxicity compared with sequential, single-agent chemotherapy. Research involving biologic therapy continues to provide encouraging results for patients with metastatic breast cancer. Chemotherapy plus trastuzumab has been shown to result in greater overall survival versus chemotherapy alone in human epidermal growth factor 2 (HER-2)-positive patients. Trastuzumab has been associated with cardiotoxicity when administered with conventional anthracyclines. Newer formulations of anthracyclines have been developed (e.g., liposomal anthracyclines) to decrease the incidence of cardiotoxicity, and these provide additional treatment options for patients with metastatic breast cancer. The potential effect of all of these endocrine, chemotherapeutic, and biologic treatments on quality of life is an important consideration. Additionally, integrating patient concerns into treatment decisions and collaborating with cross-disciplinary healthcare providers can help to manage the disease more effectively.

show abstract

“…Les toxicité s de grades 3 et 4 é taient, dans pratiquement tous les cas, plus fré quentes pour les associations. Par contre, seulement deux é tudes montraient une diffé rence significative entre les deux bras pour les scores de QdV pour certains paramè tres (é tude FEC versus mitoxantrone) [33] ou à certains temps de mesure (é tude gemcitabine plus paclitaxel versus paclitaxel) [45]. Dans l'interpré -tation clinique des ré sultats de QdV obtenus dans cette derniè re é tude, Hopwood et al observaient que l'amé lioration de la QdV é tait significativement associé e à la ré ponse tumorale et au nombre de cycles complé té s tandis qu'une alté ration de la QdV é tait plutô t associé e à la dé té rioration du fonctionnement et de l'é tat psychologique plutô t qu'à la toxicité du traitement [36].…”

Section: Vers Un Meilleur Choix Thé Rapeutiqueunclassified

Chemotherapy and quality of life in metastatic breast cancer: taking stock

et al. 2008

View full text Add to dashboard Cite

Quality of life (QoL) is of particular importance in the study of pathologies requiring arbitration between the side effects and the expected clinical benefit of a treatment. The choice of a monotherapy over polychemotherapy in the treatment of metastatic breast cancer is a good example of this problem and often corresponds with a difference in terms of expected end result, i.e. a rapid objective response for polychemotherapy and the preservation of QoL for monotherapy. This way of looking at things remains debatable in view of the results of various controlled trials. Few randomised studies reported major differences in terms of QoL between the treatment groups. The limits concerning the methodology of these clinical trials could partially explain these results. The development of standard guidelines for implementing QoL studies in clinical trials as well as the development of increasingly reliable and specific measuring instruments should allow the regrouping of objectives and the optimization of results in order to improve exploitation of QoL data. Keywords: Chemotherapy -Quality of life (QoL) -Metastatic breast cancerRé sumé : Les é tudes de qualité de vie (QdV) pré sentent un inté rê t majeur dans l'é tude des pathologies né cessitant un arbitrage entre les effets indé sirables du traitement et le bé né fice clinique attendu. Le choix d'une monochimiothé rapie plutô t qu'une polychimiothé rapie dans le traitement du cancer du sein mé tastatique (CSM) s'inscrit parfaitement dans cette problé matique et correspond souvent à une diffé rence en termes d'objectifs avec l'obtention d'une ré ponse objective rapide pour la polychimiothé rapie et la pré servation de la QdV pour la monothé rapie. Cette repré -sentation reste toutefois discutable au vu des ré sultats des diffé rentes é tudes cliniques contrô lé es. Peu d'é tudes randomisé es ont rapporté des diffé rences majeures au niveau de la QdV entre les groupes de traitement. Les limites lié es à la mé thodologie de ces essais cliniques peuvent expliquer en partie ces ré sultats. L'é laboration de recommandations standard pour la mise en place d'é tudes de QdV dans les essais cliniques ainsi que la mise au point d'instruments de mesure de plus en plus fiables et spé cifiques devraient permettre de recentrer les objectifs et d'optimiser les ré sultats afin d'exploiter davantage les donné es de QdV.

show abstract

Gemcitabine plus paclitaxel (GT) versus paclitaxel (T) as first-line treatment for anthracycline pre-treated metastatic breast cancer (MBC): Quality of life (QoL) and pain palliation results from the global phase III study

Cited by 25 publications

References 0 publications

Gemcitabine in the management of metastatic breast cancer: a systematic review

Gemcitabine in the management of metastatic breast cancer: a systematic review

Optimizing the treatment of metastatic breast cancer

Chemotherapy and quality of life in metastatic breast cancer: taking stock

Contact Info

Product

Resources

About