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Gemcitabine and carboplatin for pretreated metastatic breast cancer: the predictive value of immunohistochemically defined subtypes

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Abstract

Background

We evaluated the efficacy of gemcitabine and carboplatin for patients affected by pretreated metastatic breast cancer. A subgroup analysis was performed to evaluate the predictive value of immunohistochemically defined breast cancer subtypes.

Methods

We included human epidermal growth factor 2 (HER-2) negative metastatic breast cancer resistant to previous anthracycline-based and taxane-based chemotherapy, and HER-2 positive metastatic breast cancer with at least two progressions of disease during protracted trastuzumab-based therapy. Treatment consisted of gemcitabine (1000 mg/m2 intravenous (iv) on days 1 and 8) and carboplatin (area under the curve 5 iv on day 1) applied every 3 weeks.

Results

Forty-two patients were registered. Disease control was 58%, with a median time-to-progression (TTP) of 7 months (range 1–12) and a median overall survival of 10.5 months (range 1–34). Patients were grouped as triple negative (ER and PR negative, HER-2 negative), HER-2 (HER-2 positive, ER and PR negative), luminal B (ER and/or PR positive and either HER-2 positive and/or high Ki67), and luminal A (ER and/or PR positive and HER-2 negative and low Ki67). For luminal A patients, disease control was lower (luminal A 34 vs. others 67%; P = 0.02), TTP was shorter (luminal A 2.4 months vs. others 6.3 months, P = 0.015), and overall survival was shorter (luminal A 7.5 months vs. others 11.7 months, P = 0.034) than for other subtypes.

Conclusions

Gemcitabine and carboplatin are effective for pretreated patients with metastatic breast cancer. Luminal A subtype seems to fare poorly compared with other subtypes. Specific difference in gene expression might account for the different outcome.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Central Hospital of Belcolle, Strada Sammartinese snc, 01100, Viterbo, Italy

    Fabrizio Nelli, Luca Moscetti, Guido Natoli, Giuliana D’Auria, Mario Chilelli, Maria Agnese Fabbri & Enzo Maria Ruggeri

  2. Department of Pathology, Central Hospital of Belcolle, Viterbo, Italy

    Annalisa Massari

  3. Department of Breast Surgery, Central Hospital of Belcolle, Viterbo, Italy

    Patrizia Frittelli

Authors
  1. Fabrizio Nelli
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  2. Luca Moscetti
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  3. Guido Natoli
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  4. Annalisa Massari
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  5. Giuliana D’Auria
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  6. Mario Chilelli
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  7. Maria Agnese Fabbri
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  8. Patrizia Frittelli
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  9. Enzo Maria Ruggeri
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Correspondence to Fabrizio Nelli.

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Nelli, F., Moscetti, L., Natoli, G. et al. Gemcitabine and carboplatin for pretreated metastatic breast cancer: the predictive value of immunohistochemically defined subtypes. Int J Clin Oncol 18, 343–349 (2013). https://doi.org/10.1007/s10147-012-0384-x

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  • DOI: https://doi.org/10.1007/s10147-012-0384-x

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