When it looked like I was having a problem with the Xeloda my onc said he would finish my treatments with Gemzar. So, I think they are interchangable.
The Navelbine, though, is a different type of chemo than the Xeloda or the Gemzar-
Navelbine is a plant alkoloid and Gemzar and Xeloda are both antimetabolites.
I do think that it is the combo that is considered, true? Navelbine WITH either Gemzar or Xeloda?
Weren't you already on Xeloda?
I would try the Navelbine and Gemzar because you haven't been on those two and it may be just the switch your body needs. And they have been proven to be powerful together against cancer.
Here is something I found for you:
An oral (tablet form) derivative of 5-FU with activity against breast cancer is available (Xeloda® [capecitabine]). When used alone for the treatment of patients with breast cancer that has progressed in spite of multiple prior therapies, about 20 percent of women have a response, including those whose breast cancers have responded poorly to intravenous 5-FU.
- Side effects — 5-FU and related drugs are less likely than many other chemotherapy drugs to cause hair loss or suppress bone marrow function. Furthermore, fewer than 10 percent of women experience nausea and vomiting when treated with these drugs. However, 5-FU and related drugs can cause other gastrointestinal symptoms, including diarrhea and inflammation of the mouth (mucositis). The dose of Xeloda may be reduced if a temporary side effect called hand-foot syndrome develops. This causes the skin of the palms and soles of the feet become red and sore, sometimes with peeling.
Gemcitabine — Gemcitabine (Gemzar®) has a low frequency of side effects such as nausea, vomiting, hair loss, and temporary suppression of bone marrow function. It is more often used,in combination with paclitaxel (see above), for treatment of metastatic breast cancer in patients whose disease has progressed while receiving anthracycline-containing regimens.
Vinca drugs — Vinorelbine (Navelbine®) is the most widely used vinca-type drug for advanced breast cancer. Weekly administration results in a response in over 50 percent of women.
- Side effects — All of these agents can cause damage to the nervous system, which may cause a feeling of numbness and tingling in the fingers and toes (called peripheral neuropathy). This typically develops after several courses of therapy, and is usually reversible when treatment is stopped. Vinorelbine is less likely than vincristine to cause peripheral neuropathy, and the likelihood of bone marrow suppression is low. Occasionally, vinca alkaloids can cause sudden, severe pain around the tumor that begins during or immediately after the drug is administered, and lasts several minutes to hours.
Summary — Among the many chemotherapy drugs available for treatment of metastatic breast cancer, the most active are the anthracyclines and taxanes. Taxanes are often used first in women with metastatic breast cancer whose cancers are unlikely to respond to hormone therapy, and for breast cancers that have recurred after other types of chemotherapy. An anthracycline combination may be used for women who have not previously received anthracycline or those who have had a recurrence more than 12 months since anthracyclines were used. Xeloda, Navelbine, and Gemzar are good second or third-line options, or they may be used as a first line treatment in combination with a taxane.
Due to the small survival difference and more favorable side effect profile, therapy with serial single agents is a reasonable alternative to combination regimens, especially in the second, third, or fourth-line treatment setting (show figure 1). On the other hand, for symptomatic patients or those with rapidly progressive vital organ metastases, combination therapy may be a more appropriate first-line choice because of the greater likelihood of an objective response.http://patients.uptodate.com/topic.asp?file=cancer/8347