gic toxicity in 15 patients, and nonhematologic toxicity in 2 patients. Two patients required a second dose reduction for hematologic Pemetrexed toxicity, which meant the dose was reduced to 50% of the initial dose. A hypersensitivity reaction was observed in 1 patient during administration of gemcitabine in the second cycle. The symptoms include flushing, tachycardia, pruritus, and RAF Signaling Pathway chest discomfort and were released by discontinuation of gemcitabine and administration of steroids and antihistamines. Prognostic factors Patients were dichotomized into disease control group and uncontrolled group. v2 test revealed no predictive factors for disease control. Response to chemotherapy was found to be the only one prognostic variable for PFS.
ECOG performance status of 0, less than 3 metastatic locations, and absence of visceral metastasis were associated with an increase in overall survival. In the multivariate analysis, ECOG performance status was the only predictive factor for OS. Discussion Despite great improvements have been made in the treatment of MBC, there are still Syk Signaling Pathway several unmet needs. Among them are to determine appropriate standard of care for those with previous exposure to anthracycline and taxane and to develop predictive factors, which will help to select patients who are most likely to benefit from a particular agent and to avoid unnecessary toxicity of ineffective treatments. Our study tried to investigate the efficacy and toxicity of combination therapy of gemcitabine and vinorelbine in elderly patients with anthracycline and taxanepretreated MBC and to explore reliable prognostic factor for disease control, PFS, and OS.
In fact, the use of combination therapy in the palliative setting is not well argued. An overview of randomized phase II and III trials comparing gemcitabine in combination with vinorelbine versus single agent or sequential cytotoxic Decitabine 1069-66-5 agent demonstrated conflicting results. Some studies showed that combination treatments were associated with a significant prolongation of PFS and significantly higher objective response rate, while others not. In a phase III trial, gemcitabine and vinorelbine combination therapy was shown to be superior to single agent vinorelbine in both PFS and objective response rate, with manageable toxicities.
In a phase II study comparing gemcitabine and vinorelbine combination therapy with sequential gemcitabine and vinorelbine therapy, although no difference in efficacy was found between the two arms, patients in the combination arm federal state reported an improvement in quality of life in the presence of similar episodes of adverse events. Another phase III study of gemcitabine plus vinorelbine versus single agent capecitabine demonstrated no superiority of doublet over single agent in terms of objective response, or PFS. Given the favorable toxicity profiles and convenient administration, single agent capecitabine was recommended for compliant patients. To our knowledge, up to now there is no head to head comparison of gemcitabine plus vinorelbine versus sequential or single agent in elderly patients. Our study showed that gemcitabine plus vinorelbine was an effective and safe therapeutic option, yielding a response rate of 33.3%, median PFS 6.2 months, and median OS 17.0 months. Response rates with gemcitabin