Gezmar

KDR · 02-19-2011, 07:19 AM

My friend and co-patient, Bonnee, is going on Gezmar after having signifcant progresson on Navelbine. She is dealing with recurrence, has been fighting five years and and is HER2 negative. So, if anyone has info on Gezmar, I really would love some feedback. Her onco gave her some really encouraging news, though, she has lots of years to go...not to give up. And thanks for your prayers and warm thoughts, her brain MRI was clear.

Jackie07 · 02-19-2011, 08:34 AM

Karen,

The following abstracts give positive result of Gemzar - especially for Her2 negative patients :

Am J Clin Oncol. 2011 Jan 26. [Epub ahead of print]
Phase II Trial of Pegylated Liposomal Doxorubicin in Combination With Gemcitabine in Metastatic Breast Cancer Patients.
Jacquin JP, Chargari C, Thorin J, Mille D, Mélis A, Orfeuvre H, Clavreul G, Chaigneau L, Nourissat A, Dumanoir C, Savary J, Merrouche Y, Magné N.
Departments of*Medical Oncology ‡Public Health, Statistical Unit **Radiotherapy, Institut de Cancérologie de la Loire, St Priest en Jarez †Service of Oncology Radiotherapy, Hôpital d'Instruction des Armées du Val-de-Grâce ¶Department of Oncology Development, Laboratoire Schering Plough ♯Department of Oncology Development, Laboratoire Elli Lilly, Paris §Department of Medical Oncology, Centre Hospitalier de Bourg en Bresse, Bourg en Bresse ∥Department of Medical Oncology, Centre Hospitalier Universitaire Jean Minjoz, Besançon, France.
Abstract
OBJECTIVE: To assess the efficacy and toxicity of pegylated liposomal doxorubicin combined with gemcitabine as first-line chemotherapy in metastatic breast cancer patients in a phase II trial.
PATIENTS AND METHODS: All breast cancer patients with HER2-negative status, hormone refractory tumor, assessable targets, with preserved performance status, and who had not received chemotherapy earlier as treatment for their metastatic disease were eligible. The patients received pegylated liposomal doxorubicin (30 mg/m, venous injection, day 1) concurrently with gemcitabine (1000 mg/m, venous injection, days 1 and 8), 1 cycle every 3 weeks.
RESULTS: Although 38 patients should have been included, this study was prematurely discontinued after recruiting 20 patients because of excessive toxicity: 75% of the patients experienced grade 3 or 4 treatment-related toxicity, including neutropenia, thrombopenia, hand-foot syndrome, and stomatitis, which significantly affected the quality of life. Cardiac toxicity was mild. With regard to efficacy, 50% of the patients (95% confidence interval, 26%-74%) experienced tumor response. The response rate was 40% in patients who had earlier received anthracyclines as adjuvant therapy. Median progression-free survival and median overall survival were 8.8 months and 19 months, respectively.
CONCLUSIONS: This combination was efficient, but not well tolerated. From these results, we could not recommend these doses for further assessment and lower doses should be preferred.

Med Oncol. 2011 Jan 25. [Epub ahead of print]
Safety and efficacy of gemcitabine plus cisplatin combination in pretreated metastatic breast cancer patients.
Brito LG, de Andrade JM, Lins-Almeida T, Zola FE, Pinheiro MN, Marana HR, Tiezzi DG, Peria FM.
Department of Gynecology and Obstetrics, School of Medicine of Ribeirão Preto, São Paulo University, Avenida Bandeirantes, 3900, 8th Floor, Ribeirão Preto, SP, 14048-900, Brazil, lgobrito@gmail.com.
Abstract
Metastatic breast cancers (MBC) previously treated with anthracyclines (A) and taxanes (T) have a complicated management. Gemcitabine (G)-cisplatin (C) combinations have been used as synergistic salvage therapy in MBC and are considered as another option for patients with important symptoms and aggressive visceral disease. We analyzed the safety and efficacy of GC in AT-pretreated MBC, as well as overall survival (OS) and time to progression (TTP). Forty-nine subjects received IV G 750 mg/m(2) and C 30 mg/m(2), both d1 and d8 every 3 weeks. Response evaluation was performed every second cycle and in the end of treatment. GC protocol was the first-line palliative chemotherapy in half of the cases, and median number of cycles/patient were 4(2-12). Lung (75.5%) was the most frequent site of metastasis. Most of the patients related clinical improvement with chemotherapy with minimal/mild tolerable collateral effects in 85.7% of cases. Following 34 months, mean OS/TTP was 13.12/6.6 months. Objective-responded patients (40.3%) were statistically associated with the improvement in symptoms after CT (P < 0.01), and OS was directly correlated with chemotherapy response (P < 0.01). HER-2 overexpression was a prognostic factor with reduced OS (P = 0.01). GC protocol was effective and tolerable in objective-responded patients
Med Oncol. 2010 Dec 31. [Epub ahead of print]
Gemcitabine and cisplatin salvage regimen in heavily pretreated metastatic breast cancer: a Brazilian experience.
de Lima Araújo LH, Moitinho MV, Silva AM, Gomes CA, Noronha Júnior H.
Hospital de Câncer III, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil, laraujo@inca.gov.br.
Abstract
Gemcitabine and cisplatin combination (Gem-Cis) is a commonly used regimen in metastatic breast cancer (MBC), with proven activity in phase II trials. It is mostly used as a salvage regimen for progressive disease refractory to anthracyclines and taxanes, and when liver dysfunction secondary to liver metastasis precludes these drugs. Retrospective review of medical charts was conducted for patients treated with Gem-Cis for MBC in a single institution in Brazil between January 2004 and July 2007. The purpose of this study was to evaluate the outcomes and toxicity of Gem-Cis in a broad indication, including patients with deteriorated performance status (PS) and liver dysfunction, which were excluded from clinical trials. Fifty-six patients were included. Median age was 52 years, 46.4% were hormone-receptor negative, 57.2% received 3 or more prior chemotherapy lines, and 34 had liver metastasis. The median overall survival (OS) was 7.6 months, the median progression-free survival was 3.3 months, and the response rate was 21.2%. In variable analysis, PS was significantly associated with OS, even after adjusting to other factors. Toxicities included grades 3 or 4 anemia in 19.3%, neutropenia in 21.1%, and thrombocytopenia in 12.3%. Gem-Cis was a relatively active combination in this population that typically carries a poor prognosis. The subgroup of patients with favorable PS experienced longer survival, even when liver metastasis and hepatic dysfunction were a concern. Toxicity was manageable and it was not correlated with PS or liver dysfunction.

KDR · 02-19-2011, 09:00 AM

Thanks. As usual, I have a hard time reading these medical abstracts. Anyone else have real-person experience with Gezmar?

Jackie07 · 02-19-2011, 09:17 AM

I hope some of our Her2 members who have the experience with Gemzar will chime in.

The following link contains discussions from another forum:

http://www.hystersisters.com/vb2/sho...d.php?t=239905

Jackie07 · 02-19-2011, 11:47 AM

Anyone with Gemzar/Gezmar experience to share?

http://www.chemocare.com/bio/gemzar.asp

02-20-2011, 05:31 AM

Quote:

first-line chemotherapy

progression-free survival and median overall survival were 8.8 months and 19 months, respectively

It's hard to believe in that statistics. Who are that people and how can it be understood? Why this forum shows other statistics? Are there drugs or methods of preventing and cure? Thank you...

Jackie07 · 02-20-2011, 05:40 AM

From Wikipedia:

In probability theory and statistics, a median is described as the numeric value separating the higher half of a sample, a population, or a probability distribution, from the lower half. The median of a finite list of numbers can be found by arranging all the observations from lowest value to highest value and picking the middle one. If there is an even number of observations, then there is no single middle value; the median is then usually defined to be the mean of the two middle values.[1][2]

The statement shows that 50% of the patients did not show progression at 8.8 months. Median overal survival was 19 months - meaning that half of the patients lived uner 19 months and half of them are living over 19 months.

There are some information in the 'Home' page about drugs/methods of treating Her2 breast cancer. Please use the 'Search' button to look for 'Long-term' and 'long-time' suvivors.

This thread is about Gemzar which is a new drug still undergoing clinical trials for breast cancer. Please don't lose heart.

Chelee · 02-20-2011, 05:28 PM

KDR,
I have never had Gemzar...but my Mother was battling advanced lung cancer and was on Gemzar at one point. She was 77 yrs old so I was worried about the SE's...especially with her other health issues. But she did really well on it. She even told me it wasn't bad at all. She had been on several chemo's and the others were hard on her compared to Gemzar.

I remember she didn't lose her hair on Gemzar either. It thinned out a little bit but not much at all. Her biggest complaint if you want to call it that was some fatigue...other then that she did really well on it. Hope that helps some?

Chelee