Due to poor accrual

The optimal treatment for pretreated patients with metastatic breast cancer has not been established. Gemcitabine and capecitabine are two active agents in this setting. For women with Her-2 positive breast cancer, combinations of either gemcitabine or capecitabine (Xeloda) plus Herceptin has been proved active and well tolerated.

This trial compares the efficacy of the combinations gemcitabine plus Herceptin versus capecitabine (Xeloda) plus Herceptin in pretreated patients with metastatic HER-2 positive breast cancer.

Inclusion Criteria:

• Informed consent
• Histologically confirmed metastatic breast adenocarcinoma (stage IV) without any prior chemotherapy received
• HER-2 overexpression 2+ or 3+ using IHC or FISH +
• Measurable disease
• At least one prior chemotherapy regimen
• Not in a prior irradiation field
• No patients with brain metastatic disease who has not been irradiated or uncontrolled brain metastatic disease after irradiation
• No more than 25% of myeloproductive bone marrow irradiated. More than 4 weeks since prior radiotherapy and recovered
• Age 18 - 75 year old
• Performance status (WHO) 0-2
• Life expectancy more than 12 weeks
• Absolute neutrophil count > 1500/mm^3, platelet count > 100000/mm^3, hemoglobin > 9 gr/mm^3)
• Adequate liver (bilirubin < 2 mg/dL, SGOT/SGPT < 2 times upper limit of normal, ALP < 3 times upper limit of normal, creatinine < 1.5 upper limit of normal
• Adequate cardiac function (LVEF > 50%)

Exclusion Criteria:

• Pregnant or nursing
• Positive pregnancy test
• Concurrent agents ketoconazole, macrolide antibiotics, zidovudine which may induce P-450 cytochrome
• Motor or sensory neuropathy > grade 1 according to NCIC toxicity criteria
• History of allergic reaction attributed to docetaxel
• Psychiatric illness or social situation that would preclude study compliance
• Other concurrent uncontrolled illness
• Other invasive malignancy within the past 5 years except cured basal cell skin carcinoma and cervical carcinoma in situ