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Integrating gemcitabine into breast cancer therapy.

Gemcitabine (Gemzar) possesses meaningful antitumor activity in the treatment of breast cancer, repeatedly demonstrating superior outcomes without the price of excessive toxicity in most patients. In combination with other agents, it has a potential for nonoverlapping toxicities, a novel mechanism of action, as well as a potential lack of complete cross-resistance. Randomized phase III trials with gemcitabine have yielded response rates that have translated into time to disease progression and survival benefits. Thus, enthusiasm continues for gemcitabine, especially in combination with other cytotoxic agents. The augmentation of efficacy (ie, response rates, time to disease progression, overall survival) by the addition of gemcitabine to paclitaxel has established this regimen as a first-line treatment option for patients who might benefit from combination therapy. Gemcitabine now remains under active investigation for the treatment of early-stage breast cancer, with ongoing trials characterizing its role in the neoadjuvant setting.