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Taxol every week or every other week?

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mopnglo42 View Drop Down
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    Posted: 28 Feb 2011 at 2:07pm

I was wondering if anyone knows of any published literature out there stating the difference between Taxol every week for 12 weeks or Taxol every other week for 8 weeks.  I didn't know if one was better than the other or if it is personal preference.  Any information or advice on this would be greatly appreciated.  My onc said that I could do either/or.  Thanks in advance! (Sorry if this is a repeat topic)

Age 30
DX 1/12/11 BC, grade 3
Bilat Mastectomy 1/26/11 DCIS & TNBC, Stage 1, Grade 3, Nodes Neg
Mediport 2/7/11
BRCA neg, waiting on BART test
Started chemo 2/24/11: DD AC/T
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clwille708 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote clwille708 Quote  Post ReplyReply Direct Link To This Post Posted: 28 Feb 2011 at 2:28pm
I have just finished Taxol every two weeks- three weeks ago.  I did some research trying to find any studies and I did not succeed.  But I think the reason behind weekly for 12 weeks, is that it can be easier on your body and not quite so toxic.

It was not given as an option for me.  The downside of course, is an extra month of chemo.  I seem to have come through the Taxol quite well (not everyone does), and I am very glad to have it all behind me.

Best Wishes with your Chemo.

Linda from Ontario
Dx Aug/10,age 62, Lump & SNB Sept/10,1.7 cm, grade 3, Triple Neg, Nodes clear. Annual screening due to family history of Ovarian C. BRCA - Chemo DD AC -->Taxol 21 Rads done. Hugs -Linda
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dmwolf View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: 28 Feb 2011 at 2:48pm
Around here (UCSF) weekly for 12 weeks is considered better for TN, though I haven't seen research comparing the two schedules.  The thought is that since TN tends to be high grade, and high grade means fast proliferation, weekly metronomic chemo is better at catching the fast-growing cells in growth phase frequently.    If I had to do it over again, I would do weekly.
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 unklez Quote  Post ReplyReply Direct Link To This Post Posted: 02 Mar 2011 at 12:17am
Dear mopnglo42,

I researched this some months back for my wife.

Off the top of my head, I can not recall finding any head to head study comparing Taxol every week vs. Taxol every other week. Both these regimens exhibited similar improvements over Taxol every 3 weeks but then there were other variables in those studies like AC every 2 weeks vs. 3 weeks, etc..

From non-medical perspective: Taxol every week is probably less toxic and easier to bear for the patient and does not require Neulasta/Neupogen but takes an extra month to finish and requires more doctor visits.

See what your onc says. Most have a strong preference for one or the other and will give you reasons why.


Wife Dx: Jul/09. Age: 37. Grade: High. Size: 3cm. BRCA: -ve. Lumpectomy: Aug/09. Micromet 1/9 node. Chemo Start: Sep/09. Kicked off E5103 (Taxol reaction). Now dd ACB->dd Abraxane. Zometa (S0307).
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Post Options Post Options   Thanks (0) Thanks(0)   Quote unklez Quote  Post ReplyReply Direct Link To This Post Posted: 02 Mar 2011 at 12:20am
Uhh, re-read your post.. Did you onc say you could have Taxol either ways after AC every 2 weeks? Or was the weekly Taxol only after AC every 3 weeks?




Wife Dx: Jul/09. Age: 37. Grade: High. Size: 3cm. BRCA: -ve. Lumpectomy: Aug/09. Micromet 1/9 node. Chemo Start: Sep/09. Kicked off E5103 (Taxol reaction). Now dd ACB->dd Abraxane. Zometa (S0307).
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Cinderwee View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Cinderwee Quote  Post ReplyReply Direct Link To This Post Posted: 02 Mar 2011 at 12:21am
My med onco recommended Taxol 1x week x 12 weeks;my concern is it won't be enough.  Not necessarily the frequency of Taxol, but ONLY Taxol.  Begin date pending, anyone else had ONLY Taxol?


Thanks,
Cindy 46
DX 11/29/10
Stg1 G3 IDC ER-PR-Her2-
<1cm,cln marg,0/1 neg
No BRCA
Lumpectomy 12/28/10
MammoSite rads 1/10-1/14
Taxol/Her x12 DONE!
CVP/Her ev 3wks x4 begin 6/23
Continue Her Mar2012
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mopnglo42 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mopnglo42 Quote  Post ReplyReply Direct Link To This Post Posted: 02 Mar 2011 at 4:10am

Right now, I am doing the dose dense AC every 2 weeks then I will do Taxol.  My onc said that he was fine doing either the Taxol every week for 12 weeks or every other week for 8 weeks. He said that he would not do the Taxol every 3 weeks due to this has proved inferior to the other regimens.

Thanks for your input!
Age 30
DX 1/12/11 BC, grade 3
Bilat Mastectomy 1/26/11 DCIS & TNBC, Stage 1, Grade 3, Nodes Neg
Mediport 2/7/11
BRCA neg, waiting on BART test
Started chemo 2/24/11: DD AC/T
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dmwolf View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: 02 Mar 2011 at 3:01pm
Cinderwee,
I haven't heard of only giving taxol.  Usually, women doing 'chemo-lite' for stage I bc like yours do taxol with cytoxan (TC), which has been shown to be effective compared to AC.  I don't know of any clinical trial that looked at giving Taxol alone.  So....it might or might not be a good idea, but you will be flying blind if you follow his/her suggestion.  Did you ask your oncologist to back up this recommendation?  Also, how big was the invasive component?  If bigger than 0.5cm, in your shoes I probably would do something in addition to the taxane.  Have you gone for a second opinion?   I think you really should.
best,
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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unklez View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote unklez Quote  Post ReplyReply Direct Link To This Post Posted: 02 Mar 2011 at 8:48pm
Dear mopnglo42,
Yes definitely the once-weekly or bi-weekly regimens are superior to tri-weekly regimen. In your shoes I'd choose once-weekly but that's not backed by any hard evidence.
Please keep us apprised of your decision and rationale.

Wife Dx: Jul/09. Age: 37. Grade: High. Size: 3cm. BRCA: -ve. Lumpectomy: Aug/09. Micromet 1/9 node. Chemo Start: Sep/09. Kicked off E5103 (Taxol reaction). Now dd ACB->dd Abraxane. Zometa (S0307).
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Cinderwee Quote  Post ReplyReply Direct Link To This Post Posted: 07 Mar 2011 at 11:40pm
dmwolf - Just found out today there is <2mm of invasive tissue available, therefore Onco DX test cannot be performed.  <2mm is a good thing....  Waiting for 2 med oncos to confer and hoping for feedback by weeks' end.

Thank you,
Cindy 46
DX 11/29/10
Stg1 G3 IDC ER-PR-Her2-
<1cm,cln marg,0/1 neg
No BRCA
Lumpectomy 12/28/10
MammoSite rads 1/10-1/14
Taxol/Her x12 DONE!
CVP/Her ev 3wks x4 begin 6/23
Continue Her Mar2012
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dmwolf View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: 08 Mar 2011 at 3:42pm
<2mm is a good thing indeed!
You could probably go either way with chemo.  You would be well justified in skipping it altogether, though you might feel better psychologically if you had some chemo.  I don't know what I'd do in your shoes.
Good luck, and please keep us posted on opinions and what you ultimately decide to do.
love,
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 Ghostie Quote  Post ReplyReply Direct Link To This Post Posted: 08 Mar 2011 at 4:07pm
I did the bi-weekly dose-dense Taxol. My onc gave me the option of 12 weeks/weekly, but I had done so well with the A/C that he felt I could tolerate the bigger doses and be able to finish more quickly. He was right; although it certainly was no picnic I don't regret the course I chose.
 
That being said, I do keep reading about the possible better merits of doing the 12-week course. I don't know if the side effects are less but I suspect they are. For my part, I experienced a lot of bone pain during the Taxol treatments, some of which has stayed with me; and I've lost a lot of sensation in my feet. Since almost a year has passed since I finished, I don't think I'll be getting that back.
 
Best of luck to you whatever you decide!
Age 49, DX 8/27/09, 1.8cm, Stage I, Grade 3; lumpectomy 9/21/09, clear margins, 2 nodes removed, BRCA2+, Oncotype score 67. Finished 4 DD A/C + 4 DD Taxol on 3/18/10. Completed radiation in June 2010
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Cinderwee Quote  Post ReplyReply Direct Link To This Post Posted: 14 Mar 2011 at 2:49pm
Thank you....chemo to commence St. Patrick's day...
My med onco assures me HE (I insisted on only him, sorry no pass off to NP) will monitor me closely and if I so desire, I can hav AC after and that the sequence does not matter; that in fact at MD Anderson (where he did his internship and my understanding one of the best facilities in the country) they administer TX first.
 
I can do this, in part because of all the awesome info and support here.
 
Many thanks,
 
Cindy
Cindy 46
DX 11/29/10
Stg1 G3 IDC ER-PR-Her2-
<1cm,cln marg,0/1 neg
No BRCA
Lumpectomy 12/28/10
MammoSite rads 1/10-1/14
Taxol/Her x12 DONE!
CVP/Her ev 3wks x4 begin 6/23
Continue Her Mar2012
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