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No data on the predictive value of HER2 expression regarding response to gemcitabine in breast cancer are currently available. It has been reported that the gemcitabinecisplatin interaction is more active than the etoposidecisplatin interaction in lung cancer cells with high p185neu expression [3]. Elevated levels of HER2 extracellular domain adversely affect the efficacy of paclitaxel plus gemcitabine in advanced breast carcinoma [4
].
Our findings seem to support, even considering the low number of patients recruited, a positive interaction between HER2 overexpression and sensitivity to pegylated liposomal doxorubicin, substantially confirming the sensitivity of HER2-positive tumors to doxorubicin described previously [5]. However, considering the large use of liposomal doxorubicin or gemcitabine as single agent or in combination with other drugs in advanced breast cancer, particularly in elderly patients, it would be useful to predict the response to chemotherapy according to the HER2 expression. Moreover, since trastuzumab plus pegylated liposomal doxorubicin seems to be active and safe, these findings could provide the rationale for evaluating this combination in large scale investigations, considering the similar efficacy and improved safety profile of pegylated liposomal doxorubicin in comparison with conventional doxorubicin.
Division of Medical Oncology A, Regina Elena Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy
* Email: gia.fer{at}flashnet.it or gia.fer{at}flashnet.it
References
1. Fabi A, Papaldo P, Ciccarese M et al. Pegylated liposomal doxorubicin (PLD) and gemcitabine (G) in metastatic breast cancer (MBC) patients: A phase II study. Proc Am Soc Clin Oncol 2004; 23: 79 (Abstr 813).
2. Rivera E, Valero V, Arun B et al. Phase II study of pegylated liposomal doxorubicin in combination with gemcitabine in patients with metastatic breast cancer. J Clin Oncol 2003; 21: 32493254.
3. Tsai CM, Chang KT, Chen JY et al. Cytotoxic effects of gemcitabine-containing regimens against human non-small cell lung cancer cell lines which express different levels of p185neu. Cancer Res 1996; 56: 794801.[Abstract]
4. Colomer R, Llombart-Cussac A, Lluch A et al. Biweekly paclitaxel plus gemcitabine in advanced breast cancer: phase II trial and predictive value of HER2 extracellular domain. Ann Oncol 2004; 15: 201206.
5. Mass R. The role of HER-2 expression in predicting response to therapy in breast cancer. Semin Oncol 2000; 27 (6 Suppl 11): 4652.[ISI][Medline]
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