Cisplatin Plus Gemcitabine Versus Paclitaxel Plus Gemcitabine as First-Line Therapy for Metastatic Triple Negative Breast Cancer

Abstract

Background: Although breast cancer management has generally improved, there is still a standing challenge represented by the triple-negative breast cancer whose recurrence is highly frequent, disease-free survival shortened, and the overall survival is extremely poor. The Aim of Work: Compare between the total response rate of using gemcitabine/cisplatin versus paclitaxel/gemcitabine regimens to treat the metastatic triple-negative breast cancer cases. Materials and Methods: A random clinical trial method carried out on patients with metastatic triple-negative breast cancer who attended to the Department of Oncology and Nuclear Medicine, Suez Canal University, in 2016/2017. A random assignment used to allocate patients who are qualified to: Group (A) to receive cisplatin /gemcitabine (cisplatin 75 mg/m² on day 1; gemcitabine 1000 mg/m² on days 1 and 8) or Group (B) to receive paclitaxel/gemcitabine (paclitaxel 175 mg/m² on day1; gemcitabine 1000 mg/m² on days 1 and 8) every 3 weeks for eight cycles at maximum or until the development of disease progression or the intolerable toxic effect. Results: Cases of triple-negative breast cancer were 144 (20.9%) and those of metastatic triple-negative breast cancer were 110 (15.98%). Within a-12-month follow-up period, the total response rate of Group (A) was significantly higher than Group (B) (69.1% versus 47.3%, respectively). In addition, the median disease-free survival of Group (A) was significantly higher than that of the Group (B) (mean 7.18 versus 5.49 respectively). Conclusion: Cisplatin/gemcitabine can be used alternatively, even a superior regimen to paclitaxel/gemcitabine, for patients with metastatic triple-negative breast cancer.