Combination Drug Delivery Approaches in Metastatic Breast Cancer

Table 1

Clinically used combination regimens of nonspecific small molecule chemotherapeutic agents in metastatic breast cancer.

Classes	Regimens	Advantages	Disadvantages	References
	Doxorubicin + Cyclophosphamide
Anthracycline based	Doxorubicin + Fluorouracil	Improved RR	No significant difference in time to progression or survival, more treatment related toxicity, and less quality of life	[23, 24]
	Epirubicin + Cyclophosphamide
	Epirubicin + Fluorouracil
	Doxorubicin + Paclitaxel	Improved RR and PFS	More hematologic toxicity, cardiotoxicity	[18, 28]
Taxane based	Doxorubicin + Docetaxel
	Capecitabine + Docetaxel	Improved TTP, RR, and OS	Increased nonhematologic toxicity (diarrhea, stomatitis, hand-foot syndrome)	[25, 29, 30]
	Gemcitabine + Paclitaxel
Other combinations	Ixabepilone + Capecitabine	Improved RR and TTP in heavily pretreated patient	Peripheral neuropathy	[27]
	Cyclophosphamide + Methotrexate + Fluorouracil	Improved RR, RFS, and OS	Rapid bone loss	[31–33]

OS: overall survival; PFS: progression-free survival; RFS: relapse-free survival; RR: response rate; TTP: time to progression.