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17 rounds of Taxol/Carbo moving to Taxotere???...

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rmichaels View Drop Down
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    Posted: Mar 06 2012 at 3:04am
Hi All,
I wanted to get some feedback on Taxotere.
Mom had a CT scan result reading today and I wasn't able to attend the appt and now I have questions.  Here is a recap:
The CT scan showed a reduction in tumor sizes (breast and liver) and no new tumors present.
She has had 17 rounds of Taxol and Carboplatin...
She will now do lower doses of Taxotere weekly.
 
Let me know if anyone has has Taxotere and what your results have been - and if this helped you get NED. 
Thanks,
Rachel.
 
Mom dia 8/11 with IIb - IV by 11/11 with mets on liver. 17 rounds Taxol/Carbo then Taxotere, Cisplatin + Vinorelbine, 2 tx of Doxil, Xeloda all unsucessful. 10/12/12 Hospice @ home. Passed 11/7/12.
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Mar 06 2012 at 7:54am
Rachel,

I had Taxotere with Cytoxan.  I didn't realize you could get Taxotere weekly.  I thought Taxol could be given weekly and Taxotere every 3 weeks.  I believe the side effects are similar to Taxol.  Here's a link explaining more about Taxotere.  While it lists the side effects, your mom may not experience them all.  It just means that it could be possible.  My biggest side effect was neuropathy and the feeling of achy muscle, joints, bones.  I didn't lose my nails but for every treatment I had a thinning line, sort of how a tree looks with their rings.  As the nail grew out, you could see the different lines/ridges of when I had treatment.  

DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Mar 06 2012 at 12:30pm
Rachel, Taxotere is almost the same as Taxol, except as Donna says they don't usually go to a low dose weekly version.    Did they mean weekly Taxol?  Or, better yet, weekly Abraxane?  The latter is a version of Taxol dissolved in albumin instead of cremaphor, and it is supposed to be more effective and cause fewer side effects.  Because it doesn't have cremaphor, which most people are allergic to, it can be given without steroids, a HUGE plus.    Anyways, I'd check into whether  she can have Abraxane instead.  It is more expensive than Taxol or Taxotere, but insurance should cover it and her quality of life will likely be better on it.    They are probably looking at this as a maintenance phase of treatment - low dose version of a drug known to be effective on her tumors to keep her stable.

Good luck!!

d
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote rmichaels Quote  Post ReplyReply Direct Link To This Post Posted: Mar 06 2012 at 1:41pm

Hi There,

I just confirmed - Taxotere in a lower dose weekly vs. the every 3 week regimen of a higher dose.
How long has it take folks to reach NED?  She hasn't had a brain scan (doc says it's not needed because of no symptoms - but I disagree).  No radiation or surgery as of yet - doc wants tumors to shrink more.  Does this sound normal?  I hate it when I miss appts - I always as the tough questions and push more than the parentals.
Rach.
Mom dia 8/11 with IIb - IV by 11/11 with mets on liver. 17 rounds Taxol/Carbo then Taxotere, Cisplatin + Vinorelbine, 2 tx of Doxil, Xeloda all unsucessful. 10/12/12 Hospice @ home. Passed 11/7/12.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Mar 06 2012 at 2:14pm
Rachel,

Taxotere weekly, huh?  I'm surprised, but then again most of oncology is pretty seat of the pants, so it varies from onc to onc.   The weekly version should be easier to handle, but I wouldn't necessarily expect her to reach NED.   I don't know the percentages, but at least half of stage IV patients don't ever reach NED.  And if they do, it may last for years, or it may be fleeting.   Not reaching NED isn't necessarily a bad sign, either.  The object is to live as long as possible, and many people get years and years with stable disease.   This is especially true of bone mets.  Women live with them for up to 20 years.   The paradoxical thing is that some really aggressive cancers can be thrown into NED only to rear up much more aggressive soon thereafter, whereas more indolent cancers might never even approach NED but might also not turn super-aggressive.  They just kind of hang around without causing trouble.    So, the way to think of low dose Taxotere is probably that it's intended to be maintenance.  Enough to keep your Mom feeling good with her cancer stable, but not so much to damage her quality of life while possibly not doing much useful damage to the cancer.     This is a marathon, not a sprint.  Truly.

If you want surgery, you should see a surgeon.  Your onc probably won't suggest it.  Does she have just one liver tumor?    If she has just one or a couple and they are small, she could do radio frequency ablation for the liver.  And for her breast, surgery.  I saw an article showing that women live longer when they have their breast tumors removed.  You should see a surgeon and radiation oncologist about these matters.  Oncologists may just want to keep treating her with chemo, which may not do much to the cancer.  Chemo is important, but it is not your only defense.  Anyways, new appointments are probably in order sometime soon.    I'd even get a second opinion about the taxotere.  Like I said, it's not commonly given weekly and I doubt there's much if any data on that schedule.  I haven't seen it, at least, and I've seen data for a bunch of other taxane schedules.

Good luck,

d

DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lee21 Quote  Post ReplyReply Direct Link To This Post Posted: Mar 07 2012 at 4:10pm
Rachel,
I just posted some studies on taxanes in the NEW MEMBERS > OPEN ACCESS thread (pg 7). Many variations on the same theme.  Did not come across low dose taxane for maintenance but I didn't do a comprehensive search. A conclusion from 2 studies is that q3 week docetaxel may be preferable to weekly docetaxel because of lower toxicity and perhaps better efficacy (for metastatic BC). In the neoadjuvant setting for primary BC, one study says that weekly docetaxel is well tolerated with less toxicity.
12/9/11 @59,IDC,grade3, TNBC,3cm(MRI),SLNB0,stage IIA, BRCA1 variant
1/30/12 DD AC-T, 6/7/12 Lumpectomy, ypT1b(0.8 cm), 7/9/12 Rads x 30
11/9/12, clinical trial cisplatin/rucaparib, cisplatin-only arm
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