Study Finds Two Metastatic Breast Cancer Treatment Combinations Work Similarly Well
Researchers looked at two past studies on how well the chemotherapy medicines gemcitabine (Gemzar) and capecitabine (Xeloda) work when each one is paired with another chemotherapy medicine called docetaxel (Taxotere). They found that the two combinations worked similarly well, but people who took the capecitabine-docetaxel combo were more likely to stop their therapy because of side effects.
Background and Goals
Breast cancer is considered metastatic, or stage IV, when it has spread to a part of the body outside of the breasts and nearby lymph nodes, such as the brain, liver, bones or lungs. Many chemotherapy medicines can be used to treat metastatic breast cancer, including gemcitabine, capecitabine and docetaxel. Research shows that giving chemotherapy combinations that use gemcitabine with a kind of chemotherapy called a taxane, such as docetaxel, or capecitabine with a taxane could work better than giving a taxane by itself. But it’s still unclear which combination works better.
Two recent trials compared gemcitabine with docetaxel versus capecitabine with docetaxel. This study looked at information from both of those trials to come up with a broader answer to which combination works better.
The two phase III trials, the Chan trial and the Seidman trial, involved a total of 780 adults with metastatic breast cancer. Participants randomly received either gemcitabine with docetaxel or capecitabine with docetaxel.
The main focus of the trials was progression-free survival (PFS), referred to as time to progression (TTP) in the Seidman trial, the time from when participants were divided into groups at the start of the trial to disease growth or death. The trials also looked at other factors, including side effects and overall survival, OS, the time from when participants were divided into groups to death from any cause.
There was no statistically significant difference in OS or PFS/TTP between the two treatment groups:
- Median OS was 21.5 months for gemcitabine-docetaxel and 22 months for capecitabine-docetaxel.
- Median PFS/TTP was 8.5 months for both groups.
The two treatment groups did differ, however, in the impact side effects had on them. Treatment was stopped because of side effects by
- 28.4 percent of people who took capecitabine and docetaxel
- 18 percent of people who took gemcitabine and docetaxel
What This Means for You
Treatment for metastatic breast cancer should help you live the best life you can while dealing with a chronic illness. Combining medicines can give you the benefits of multiple treatments that treat cancer in different ways. But it can also make you feel more side effects than you would while taking fewer medicines.
Because of the similarities between the treatment combinations in this study, researchers say neither can be called better than the other for everyone. And it is still not proven that taking those medicines at the same time is any better than taking them one after the other. When talking to your doctor about treatment options, it’s important to consider the specifics of your situation.
The researchers suggest gemcitabine plus docetaxel, followed by capecitabine, could be a good treatment for metastatic breast cancer. They note that at this time, capecitabine plus docetaxel is approved by the FDA for treatment of metastatic breast cancer, while gemcitabine plus docetaxel is not. Gemcitabine is approved for use with another taxane, called paclitaxel (Taxol).
Seidman, Andrew D.; Chan, Stephen; Wang, Jin. A Pooled Analysis of Gemcitabine Plus Docetaxel Versus Capecitabine Plus Docetaxel in Metastatic Breast Cancer. The Oncologist. Vol. 19, No. 5, May 2014; doi: 10.1634/theoncologist.2013-0428.