completed 6 rounds Carboplatin/Taxol/Avastin – need advice

Portal Forums Cancer Treatments / Symptom Management Conventional Chemotherapy completed 6 rounds Carboplatin/Taxol/Avastin – need advice

This topic contains 2 replies, has 3 voices, and was last updated by  Dr. Ben Creelan 1 year, 10 months ago.

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January 24, 2016 at 9:55 am  #1272714    

Good-life

1st line of treatment – Doc has offered me rounds 7 and 8. I understand these rounds are optional. Not everyone can complete 6 full rounds let alone do 2 more. My question to all of you: what’s the benefit of doing round 7 & 8? do they offer more shrinkage than the first 6 rounds offered? I’ve heard that once round 6 is complete that 7 & 8 don’t necessarily reduce disease load much more.

Has anyone completed rounds 7 & 8? curious as to what their benefit was? also what might be some risks I should consider? since I haven’t become resistant to this cocktail, could I pick up rounds 7 & 8 in the future, say months or even years later?

January 24, 2016 at 10:22 am  #1272718    
JimC Forum Moderator
JimC Forum Moderator

Hi Good-life,

Welcome to GRACE. Many oncologists prefer just 4 cycles of platinum-based chemotherapy, as the amount of response with more rounds tends to be minimal, and that would especially be true if you go beyond 6 cycles. On the other hand, if scans show that there was significant continued shrinkage from round 4 to round 6, that might make two more cycles a more attractive option. That’s something to discuss with your oncologist.

The risk of continuing treatment is increased toxicity, especially damage to bone marrow function, primarily as a result of the carboplatin. In such cases, if progression appears it may be difficult to tolerate a different regimen soon after completing the current one.

Although many oncologists will not repeat platinum-based therapy after the initial treatments, if the response to first-line therapy is long lasting (probably at least 6-12 months), then a return to the first line regimen may be considered. Even so, there is often a strong preference to switching to a new therapy.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

January 25, 2016 at 6:55 pm  #1272742    

Dr. Ben Creelan

If asking whether to continue carbo/taxol past 6 cycles, then I vote no. You risk getting bad neuropathy, without any proven benefit. There are chemotherapy trials comparing 8 cycles to 4 cycles which failed to show benefit. There is recent meta-analysis showing similar outcomes for 4 cycles compared to 6 cycles. I think most would advocate for doing Avastin alone after finishing 4 – 6 cycles.

You will also have a higher cumulative risk of getting an allergy to the carboplatin.

Dr. West discusses this issue here: http://cancergrace.org/lung/2007/01/17/duration-of-chemo-in-advanced-lung-cancer/

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