Despite the common clinical use of numerous active cytotoxic agents for breast cancer therapy, and the combinations that are derived from them, the median survival for patients with metastatic breast cancer has not been dramatically improved over the past two decades. Furthermore, when the expected outcome of treatment is not cure, optimizing the dynamic equilibrium between chemotherapy-induced side effects and the benefits attributable to chemotherapy-mediated relief of cancer-related symptomatology becomes paramount. The search for active agents to this end has recently included the clinical evaluation of the novel nucleoside analogue gemcitabine (2′,2′-difluorodeoxycytidine). This review summarizes the recent and current development of this agent.

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