Let's Talk About Chemotherapy - A/C good response; Taxol poor

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A/C good response; Taxol poor

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Category: TNBC Forums
Forum Name: Let's Talk About Chemotherapy
Forum Description: A place to discuss Chemotherapy
URL: http://forum.tnbcfoundation.org/forum_posts.asp?TID=12879
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Topic: A/C good response; Taxol poor

Posted By: KK1722
Subject: A/C good response; Taxol poor
Date Posted: May 27 2016 at 2:55am

Hello Fellow TNBCs,

I'm still in the process of NAC before MX, just one chemo dose left next week, and have a question.

My NAC treatment plan included ACT only - 4 doses A/C, followed by 4 doses Taxol. My initially large tumor (5.1 cm) shrank to 1.5 cm with the 4 doses of A/C, so pretty good response! But now I'm almost done with 4 Taxol doses (3 completed), and today's sonogram showed the tumor is 1.2 cm x 1.2 cm, which means Taxol has caused for less shrinkage than A/C (1.5 --> 1.2 cm).

Anyone else have such minimal or non-response to Taxol despite responding well to A/C? And if so, any protocol for changing chemo plan while process is ongoing, such as maybe doing another dose of A/C rather than having my last dose of Taxol next week? I would rather try another round of a chemo that is effective than one that seems ineffective.

On the other hand, any realistic expectation cellularity is decreasing within remaining tumor while on Taxol even though tumor size not decreasing? (I know..... probably just wishful thinking here.)

Thanks in advance!

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Dx 1/16: IDC TNBC stage IIB, 5.1cm, 0/3 nodes, Gr3, Ki67- 99%.
37 years old. BRCA neg.
NAC - AC/T
Dbl MX June 2016. RCB II.
1.2cm residual high grade tumor.
RADs 9/16-11/16
Adj. Tx - Unknown

Replies:

Posted By: tnbc1984
Date Posted: May 27 2016 at 9:01am

Hi KK,

I had a similar response. My tumor measured 3.2cm on MRI & ultrasound but felt more like 7cm (I have still not received a great explanation as to why it felt so much larger). Either way, with AC, I felt noticeable shrinkage in both the tumor and lymph nodes. Unfortunately with Taxol, the size didn't change but the Oncologist assured me it was getting softer. I also asked about more AC or adding Carboplatin and they insisted that we needed to complete the original plan as even though the tumor wasn't shrinking, it also wasn't growing and the chemo could still be doing it's job. They described it as a cookie crumbling so even though the tumor is still there, the pathology might show that there are big holes in it.

My final pathology showed 2.1cm remaining but low cellularity (1% was invasive) so that is definitely a possibility for you. Sentinel lymph nodes were negative which I am told is important. Don't get discouraged...you're almost done with chemo!!

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Dx June 2015 IDC TN 3.2 cm, Grade 2, BRCA negative
Chemo July 2015 (AC-T), BMX with SNB Nov 2015, Rad Jan 2016

http://icanbeatbreastcancer.blogspot.ca

Posted By: KK1722
Date Posted: May 27 2016 at 11:00am

TNBC1984,

Thank you for the reply and encouragement. I haven't heard of anyone having 2.1cm residual tumor but with such low cellularity so I wasn't considering that an option. This isn't a scientific observation, just something I've noted while scanning this forum, but it seems like everyone who gets a pCR (or anything close) has only a 5mm or smaller residual tumor. However, maybe you're right and size isn't everything. Thanks!

Best wishes to you!

Kelly

-------------
Dx 1/16: IDC TNBC stage IIB, 5.1cm, 0/3 nodes, Gr3, Ki67- 99%.
37 years old. BRCA neg.
NAC - AC/T
Dbl MX June 2016. RCB II.
1.2cm residual high grade tumor.
RADs 9/16-11/16
Adj. Tx - Unknown