Hi Bev,
Sorry no thoughts on the changing from AC to T after 2 AC doses.
You are wise to bring the info you have and discuss it with your oncologist......every one's
situation is different and you and your MD need the best plan for you.
You may want to consider asking your MD what kind of studies have been done regarding
changing from AC to T after 2 AC doses. ........and what is the expert consensus of doing such.
That being said.....want to confirm you have the 2 articles sometimes referred to on the forums
which are:
Article at start of the thread:
http://forum.tnbcfoundation.org/attention-newbies-important-new-chemo-study_topic7771.html
Research article on tau protein and microtenacles and cancer metastasis: (note: research article)
http://www.medicalnewstoday.com/releases/182239.php
Regarding the Chemotherapy Sequence Affects Early Breast Cancer Outcomes
Elsevier Global Medical News. 2011 Jan 7 article.
From my reading of the article, it appears with ADJUVANT chemo, the importance of sequencing shows
the anthracyclines-first sequence was associated with a 67% increased risk of relapse (P less than .0001) and a 2.5-fold greater risk of mortality (P = .001).
However, with NEOADJUVANT chemo,the anthracyclines-followed-by-paclitaxel sequence of neoadjuvant chemotherapy was associated with an adjusted 49% higher risk of relapse (P = .01) and a nonsignificant 28% increase in risk of all-cause mortality (P = .17), compared with the paclitaxel-first strategy. (NOTE:
nonsignificant increase in risk of all-cause mortality for neoadjuvant chemo)
With this article, it is well to remember:
This was a retrospective study. Many consider prospective studies better than
retrospective studies
Studies done only with TNBC patients are better than studies with all types of breast cancers.
(When one is looking for info with TNBC.)
Most recent studies are better than older studies which most likely used older protocols not
currently used. (This article included years 1994-2009)
Many studies used chemo protocols that are not the ones being used today for TNBC.
Many studies do not give information as to whether radiation therapy was used or not.
The effect of radiation therapy on disease is important.
It is not clear from info given if chemo was dose dense or not.
In other words, just be aware of possible limitations of a study/article and discuss the study/article
with your physician.
Have your MD give her opinion of the 2 articles.
Consider asking your MD the pros and cons of why some do the taxol first and some do the taxol last.
Since your MD is a MD Anderson in Orlando, you may get the best info so far, on why there is this
issue of taxol first or taxol last. (You can be sure many would be interested to hear the response
from a MD Anderson MD in Orlando oncologist ( with the taxol last plan) given the MD Anderson retrospective study which appears to favor the taxol first plan)
Best wishes for your discussion with your MD so that you will feel better and confidant in your
treatment plan.
With caring and positive thoughts,
Grateful for today..................Judy