• Dent S, Messersmith H, Trudeau M, Breast Cancer Disease Site Group. The role of gemcitabine in the management of metastatic breast cancer: a clinical practice guideline. Toronto (ON): Cancer Care Ontario (CCO); 2007 Jan 22. 5 p. (Evidence-based series; no. 1-12). [11 references]

Note from the Program in Evidence-based Care (PEBC) and National Guidelines Clearinghouse (NGC): 2007 Update: The systematic review portion of this evidence-based series was updated in October 2006 to reflect new evidence published since the previous search in August 2005. This new evidence generated no changes to the clinical practice guideline, and therefore the evidence-based series was not resubmitted to the Report Approval Panel (RAP) or for practitioner feedback.

• The combination of gemcitabine and docetaxel may be considered as an alternative to capecitabine and docetaxel for first- or second-line chemotherapy in patients in whom the toxicity of the capecitabine and docetaxel regimen is a concern.
• For patients with metastatic breast cancer who have received prior (neo)adjuvant anthracycline therapy, the combination of gemcitabine plus paclitaxel is superior compared to paclitaxel alone as first-line chemotherapy.
• Single-agent gemcitabine is NOT recommended for women with metastatic breast cancer who are being considered for first-line single-agent anthracycline chemotherapy.
• The combination of gemcitabine, epirubicin, and paclitaxel (GET) is NOT recommended as first-line chemotherapy for women with metastatic breast cancer who are being considered for anthracycline-based combination chemotherapy.

None provided

The recommendations are supported by randomized controlled trials and single-arm trials.

• Dent S, Messersmith H, Trudeau M, Breast Cancer Disease Site Group. The role of gemcitabine in the management of metastatic breast cancer: a clinical practice guideline. Toronto (ON): Cancer Care Ontario (CCO); 2007 Jan 22. 5 p. (Evidence-based series; no. 1-12). [11 references]

Not applicable: The guideline was not adapted from another source.

2006 Jun 27 (revised 2007 Jan 22)

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

The Program in Evidence-based Care (PEBC) is a Province of Ontario initiative sponsored by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

Cancer Care Ontario
Ontario Ministry of Health and Long-Term Care

Provincial Breast Cancer Disease Site Group

The following potential conflicts of interest were declared by the lead authors of this review (SD, MT, and HM). SD was the primary investigator of a phase II trial of gemcitabine and pemetrexed in women with metastatic breast cancer, funded by Eli Lilly and Company. MT reported receiving some free gemcitabine for several patients from the same company.

None available

This summary was completed by ECRI on August 21, 2006. The information was verified by the guideline developer on August 23, 2006. This NGC summary was updated by ECRI Institute on April 30, 2007. The updated information was verified by the guideline developer on May 9, 2007.