Taxol Treatment

I was told they do the 12 because the benefits are the same but the SEs are easier to tolerate. Don't know if that helps...

Edited by debB - Apr 03 2013 at 8:35am

Deb I read that about side effects.  How were yours with taxol.  I am reading it is a beast on fatigue. Was it known that you were TNBC when they did the chemo? I will talk to my doctor about it next time.  Was just curious.  Natilie my doctor might be saving that discussion for when we are actually close to the treatment :).   

There is not a single standard of care treatment protocol, more likely it is institution-dependent. There are basically 3 "standard" treatment regimens for TNBC (MD Anderson has its own regimen and I've never been able to get a rational explanation for why they do things the way they do).
1) DD AC -> DD Taxol (every 2 weeks x 4 cycles each)
2) DD AC -> weekly Taxol x 12 weeks
3) TAC (Taxotere, A, C every 3 weeks x 4 cycles)

In terms of head on comparison of benefits re: Taxol
1) CALGB 9741 study -- Taxol every 3 weeks vs Taxol every 2 weeks. Taxol every 2 weeks is better in terms of disease free survival and overall survival.
2) ECOG study reported in the NEJM 2008 -- Taxol every 3 weeks vs weekly Taxol.  Weekly Taxol is better.

No comparison of weekly vs every 2 week Taxol to my knowledgment.

In terms of toxicities, comparisons between weekly Taxol vs every 3 week Taxol:
weekly Taxol better in terms of myelosuppression (bone marrow toxicity) but worse in terms of neurotoxicity.

In my opinion, it is better to stick with the regimen that the hospital is most familiar with, since there are no data comparing weekly to every 2 week Taxol.  I was given Neulasta throughout my DD AC-T. I had some numbness in my fingers and toes that progressed throughout treatment, then got better when treatment was completed.  But then I received cisplatin and the neuropathy got worse.  Nothing so bad that it interferes with anything I do, just something I know is there.

12 weekly Taxol vs 2 week Taxol means 8 more infusions.  If you don't have a port, it will be a challenge.

In terms of who gets severe neuropathy, most likely it is dependent on your genetic makeup.  For example, they have found certain polymorphisms in beta-tubulin III to predispose to severe toxicities. It is an active field of investigation since in some patients, neurotoxicity is dose limiting.

Dear Julie,

I did 4 AC every other week and 4 taxol every other week.  Nobody discussed doing taxol every week.  If they had, I think I would have preferred to do the 4.  Wouldn't have wanted to extend chemo by another month.  I found the taxol to be WAY more tolerable than the AC.  No nausea or feeling sick.  I found I needed more sleep during that time, but I functioned fine during the day - worked full time, kept up with exercise, etc.  I had neuropathy in hands and feet that was tolerable and improved a lot after treatment ended and was gone around 6 months later. 

Hi Lee, I did read both those studies when I was searching the Taxol regimen.  Sounds lik e everyone's experience rings similar, more tired than AC plus neuropathy but better than AC on nausea end.  I will talk to my doctor but I am sure she will have a very good reason for her plan and I will stick with her.  Plus the biweekly is better on the work/kids/school schedule.  Thank you again ladies you are a fountain of knowledge.  <3

I had DD treatments of AC then Taxol.  I also read about the 12 weekly treatments toward the end of mine and worried if I should have had that course of treatment.  I just finished treatments this week.  I agree with everyone's statements that Taxol causes more fatigue but less nausea than AC.

For those of you that did the Taxol (i start a week from today) how was the constipation side effect with it?  Any better than AC?  My routine is one week of chemo sickness and one week of terrible hemorrhoids that is excruciating.  Hoping for some relief with the Taxol since my counts don't allow me to heal. 

Barb,

Omg, I had major constipation and hemorrhoid issues on the A/C as well (For me that was worse than the nausea). At least with the nausea you can combat it pretty good w/the meds. As far as Taxol is concerned, yes, it was much, much better. Still had some issues at times, but nothing like on the A/C. My oncologist told me that constipation is the biggest complaint on the A/C! Hopefully the Taxol will be easier on you as well. I did have extreme bone/joint pain on Taxol, so for me it was a trade off. Try doubling up on the milk of magnesia and docusate softgel stool softener, this helped me a lot. Also, proctozone works good on the hemorrhoids. This is a prescription you'll need to ask your doctor for, but I'm sure he/she will be happy to oblige. Good luck.

Hi Barb,