Other chemo's

My wife has BC with mets to the spine , liver and lung. She has completed a round of CEF and Taxotere  and is now on Gemsitibine.What would you suggest to be subsequent chemotherapy if this protocol does not work. Is it possible to be chemo resistant anf if so what else is out there.Thank you.

[CCF-RN,MSN-rf]

Dear dazld:  The more chemotherapy agents a person has had, the more likely the cancer may have developed resistance.  However, unless the toxicity is thought to outweigh any possible benefit, it may be worth trying other agents.  Some that might be considered are paclitaxel (taxol) or vinorelbine (navelbine).  Also, if the tumor is HER-2 neu positive, trastuzumab (herceptin) may be a possibility.  If the tumor is estrogen or progesterone receptor positive, nolvadex (tamoxifen) or an aromatase inhibitor may be indicated.  Hopefully, her physician can discuss available options with you.