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Is Taxol superior to Taxotere?

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Stephi View Drop Down
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    Posted: Aug 26 2009 at 9:39am
Hi!
I was diagnosed in April 09 with TNBC.  My tumor was 2.5 cm.  I had a bilateral mastectomy in June.  I have had a total of six rounds of chemo thus far - three before surgery and three after surgery.  Next, my doctor recommends six rounds of taxotere and then 2 rounds of carboplatinum.  I went to a doctor at MD Anderson (with my local oncologist's blessing) for a second opinion before beginning the next round of chemo.  He recommended six rounds of weekly taxol instead of taxotere every three weeks.  My oncologist says the decision is mine.  She feels that the difference in survival rate is about 1% when comparing taxol vs. taxotere.  She has seen more serious and permanent side effects from taxol.   My oncologist is a twenty year breast cancer survivor herself and I have faith in her.  However, I would like to hear the opinions from those of you that have done one or the other.  Does taxol appear to be superior to taxotere in treating triple negative? 
 
I will also have five weeks of rads when chemo is complete.  I want to know that I have done everything I can to prevent it from coming back.  I have three great kids and a wonderful and supportive hubby and want to be around for years and years with my family!
Best wishes to you all!  Hope everyone is having a great day!
Stephanie
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LRM216 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 26 2009 at 12:54pm
Stephi, I don't know that there is much difference.  I have been told that the taxotere is more difficult.  I received one DD Taxol out of what was to be 4 every two weeks, and got bad neuropathy right out of the gate.  Onc then switched me to the taxotere (which I now have to get that dang Neulasta shot after as well!) and I can tell you that I get worse side effects (other than the neuropathy, which is lighter than when on the Taxol) from the taxotere.  It is truly kicking my butt big time. Thank God I only have one more to go before 6 wks. of rads begins.  I also had 4 DD AC and a Neulasta shot after each of those and lived through that better than I am the taxotere.  We all react differently to each drug, so what I felt you may not at all.  I wish you the best.
 
Linda
Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Aug 27 2009 at 11:27am
I've heard that for fast growing cancers like ours, metronomic therapy (smaller frequent doses) is better than the alternative.  Which would give the edge to taxol, because it can be fractionated and given weekly for 12 weeks.  I believe that is the comparison - either 4 taxotere, 3 weeks apart, or 12 taxol, one per week.  Carboplatinum, if you are going to go that route (why is this being suggested, out of curiousity?), can be given with the taxane.  I did carbo and taxotere together and it wasn't too bad (no neuropathy aftereffects).  But if I had to do it over again, I would have combined carbo given every three weeks with weekly taxol.   But all this is hearsay.  To my knowledge, no-one has proven superior efficacy of one over the other, so long as enough drug is given.
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 Autumn10182001 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 27 2009 at 1:54pm
I would like to know why the carboplatnim.. as well.. i see that it is being used for TN for mets,  and only here have a seen it say used for non-mets...    I have asked my onc and they said it is not standard care.. i would like to know why your onc is giving carboplatnim...  i see research that it works but cant get mine to consider it for me.. any info would be great.. thank you
DX2/99 Stg I,ER+PR+ Chemo lumpectomy - Neg nodes,rads, tamox,femara. DX4/09, Stg IIB /III, TNBC IDC, Grade III, 2.5CM, mastectomy. 4AC DD,12 wkly taxol,BRAC1&2Neg, Right Mast 11/25/09
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Post Options Post Options   Thanks (0) Thanks(0)   Quote spencer Quote  Post ReplyReply Direct Link To This Post Posted: Aug 27 2009 at 4:00pm
I had 12 weeks of Taxol after 4 treat. of A/C.My oncol said that more frequent dosing of the Taxol is more effective than larger doses every 3 weeks.Hope this helps.Good luck to you
Spencer 38 TNBC 1cm stage I grade II Dx Nov 08 BRCA 1 pos bil mast with reconst lymph node neg 4 treat A/C 12 Taxol
tx done May 09
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Post Options Post Options   Thanks (0) Thanks(0)   Quote LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 27 2009 at 4:19pm

I find it so dang confusing that all the oncs tell us all conflicting things.  Wish they'd all get together and at least stick to the same theories.  While I admire my onc greatly and she came very highly recommended with great credentials, she told me just the opposite when I asked why I was getting the taxol every two weeks DD and not over 12 weeks.  She absolutely refused to change it to 12 weeks despite what other oncs were doing.  I flunked the first taxol by getting really bad neuropathy right out of the gate and she then switched me to the taxotere every 3 weeks (and the damn Neulasta shot again after each) and I have one more to go.  It's just so frustrating that they all so and say something different to each of us.  Makes me wonder, which I certainly don't need to do!

Linda
Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cg--- Quote  Post ReplyReply Direct Link To This Post Posted: Aug 27 2009 at 4:51pm
Oh LRM216,
 
They would not let me have the weekly Taxol either...I had the dose dense. AC and T - May 2007 and I really wanted the weekly.  I personally feel it is just more convenient for the doctor and it is strictly cost effective for them to have us in 4 times instead of 12 - regardless if studies say it is easier on us or more effective to have the Taxol weekly.  Traveling through the maze of medical information and the roadblocks they throw at us is confusing and frustrating - but at least we can share and draw strength from each other!
 
The good news is that I do not have neuropathy...and I am two years following treatment and I have my life back....and so will you.
 
Love,
Connie
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Post Options Post Options   Thanks (0) Thanks(0)   Quote unklezwifeonty Quote  Post ReplyReply Direct Link To This Post Posted: Aug 27 2009 at 7:52pm
Weekly Taxol is slightly better according to this study.

http://www.breastcancer.org/treatment/chemotherapy/new_research/20080417c.jsp

But 1-2% differences in a study of 2000 patients is not sufficient to base your decision. I'd start with weekly Taxol and move down the list if you experience difficulties with that. Know that every person is different.





Dx: Jul/09. Age: 37. Grade: High. Size: 3cm. BRCA: -ve. Lumpectomy: Aug/09. Micromet 1/9 node. Chemo Start: Sep/09. Kicked from E5103 due to Taxol reaction. Now on AC->Abraxane. Zometa (S0307).
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Nancy Quote  Post ReplyReply Direct Link To This Post Posted: Aug 28 2009 at 6:22am
Nancy
DD Lori dx TNBC June 13,2007
Lumpectomy due to incorrect dx of a cyst
mastectomy July 6 2007
chemo ACT all 3 every 3 weeks 6 tx Aug-Nov
28 rads ended Jan 2008
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ChrissieD Quote  Post ReplyReply Direct Link To This Post Posted: Aug 28 2009 at 6:28am
Many studies on Taxol effectiveness compare every 3 week dosing to dose dense.  Dose dense has been shown to be most effective for TNBC but many women who received every 3 weeks are past the 5 year mark too.  I do not think there have been significant studies to show dose dense every other week to weekly.  I received dose dense every other week 4 cycles of Taxol.  This was the recommended regimen from DFCI (Dana Farber Cancer Institute - Dr. Berstein) for Stage I. I was told that if I did not tolerate the Taxol well (i.e., allergic reaction) then they would switch to the other.  Perhaps it is different for different stages.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Shelly Rae Quote  Post ReplyReply Direct Link To This Post Posted: Aug 28 2009 at 8:18am

I wish they would do a study on every two weeks vs weekly. I am doing the every two weeks. This drug has not been fun. I have NOT been sick to my stomach at all which is great, but about 3-4 days out I feel like a train hit me. I get muscle, joint and nerve pain. I feel like PAC-man is inside of me running into the walls. I have iced my hands and feet at treatment and have had no problems with them. The nerve pain is in my stomach, thighs & butt, it feels like darning needles poking me. We will get through this somehow, by the grace of God!

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Post Options Post Options   Thanks (0) Thanks(0)   Quote unklezwifeonty Quote  Post ReplyReply Direct Link To This Post Posted: Aug 28 2009 at 9:09am
Originally posted by Nancy Nancy wrote:

unkle,
 
Your link made hotWink
Nancy
 
 
 


Thanks!!!


Dx: Jul/09. Age: 37. Grade: High. Size: 3cm. BRCA: -ve. Lumpectomy: Aug/09. Micromet 1/9 node. Chemo Start: Sep/09. Kicked from E5103 due to Taxol reaction. Now on AC->Abraxane. Zometa (S0307).
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Post Options Post Options   Thanks (0) Thanks(0)   Quote LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Aug 28 2009 at 10:22am

Thanks, Connie - I appreciate the support - sometimes this road just seems so confusing and long, long and then even longer!  One more taxotere to go and then, hopefully, I will be finished with chemo for good!  (I pray).

Hugs,
Linda
Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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Post Options Post Options   Thanks (0) Thanks(0)   Quote HolliBeri Quote  Post ReplyReply Direct Link To This Post Posted: Aug 28 2009 at 2:46pm
Taxol and Taxotere are cousins. Taxol is a first genration drug and has been around al long time. Taxotere is a second generation drug with supposed less side effects such as numbness in the finers and toes.
You will find that different Onc will have different opinions on chemo regimens especially in regards on the stage of the cancer and the hormone receptor status.
DX age 45:12/08 IDC & DCIS TNBC. 2/09:lumpectomy, 2 cm, grade 3, -nodes, stage IIa, BRCA- Chemo:Taxotere/Cytoxan x4.Double mastectomy 6/09. Zometa   http://www.caringbridge.org/visit/hollisimpsongough
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Post Options Post Options   Thanks (0) Thanks(0)   Quote cwrightrn Quote  Post ReplyReply Direct Link To This Post Posted: Aug 28 2009 at 3:59pm
I too had taxotere DD every 2 weeks prior to surgery (after AC) and on Monday will start rads + carboplat/taxotere again (there was residual cancer at the time of surgery). Anyway, many have mentioned neuropathies...is anyone taking glutamine? I did it with taxotere and have no neuropathies or myalgias....the dose is 15mg twice a day...it needs to be in powdered form and can be mixed with juice. I have a friend from work who didn't know about it and it has been 5 years and she suffers miserably from neuropathies. Just a thought
We are a family of FAITH, HOPE and LOVE
DX 2/09 IBC, stage IIIB, 6/15 nodes, TN, BRCA-: 1/10-stage IV, mets to mediastinal nodes, 4/10 skin mets recurrence
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