stick with docetaxol or switch to weekly pacitaxol

Portal Forums Cancer Treatments / Symptom Management Conventional Chemotherapy stick with docetaxol or switch to weekly pacitaxol

This topic contains 4 replies, has 4 voices, and was last updated by  aya1471 1 year, 3 months ago.

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August 7, 2016 at 3:34 am  #1287956    

aya1471

Hello – I have stage 4 BC with mets in my brain, liver and lungs. I am on herceptin, perzutumab and docetaxol. I have had two cycles of the docetaxol and have had quite a tough time with infections (have been on antibiotics both cycles), very bad diarrhea, thrush, generally feeling unwell and fatigued.

My medical team do not think its good for me to be so unwell and want to switch me to weekly pacitaxol. I’m concerned because i had 2-weekly pacitaxol during my primary diagnosis back in 2013 and it must not have worked as I now have secondary disease. Also the evidence on herceptin, perzutumab has been conducted with docetaxol so it’s not clear whether pacilitaxol will have the same impact.

Any thoughts??

Thanks

Maya

August 7, 2016 at 4:25 pm  #1287968    
catdander forum moderator
catdander forum moderator

Hi Maya,

Welcome to Grace. It’s very possible that paclataxol can help control progression at this point. Also, it’s just as possible the 2 treatments of paclataxol kept the cancer in check for a while as it is that it allowed the cancer to recur. If it’s possible that it would allow you to live better then all the better to give it a go. It can be dangerous to assume one similar drug will act like another however it’s not possible (financially feasible) to test all combos and often oncologists find that switching one for another is effective even without data to back it up.

I will ask an oncologist who specializes in BC to comment.

I hope you feel better soon.

Janine

August 7, 2016 at 5:09 pm  #1287972    
JimC Forum Moderator
JimC Forum Moderator

Hi Maya,

In addition to the good insights Janine provided, I’d just add that’s it’s often said that a tolerable chemo regimen is superior to one which you cannot complete due to side effects. As GRACE’s Dr. Weiss has said, “The goal of good chemo is not only killing cancer cells, but also tolerability.”

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

August 8, 2016 at 2:12 pm  #1287983    

Dr Cianfrocca

Hi Maya,
I think switching the docetaxel to weekly paclitaxel is a very reasonable option and I wouldn’t assume that it wouldn’t be effective just because you received 2 doses in the past. You may tolerate it much better than the docetaxel.
I wish you all the best,
Dr. Cianfrocca


Mary Cianfrocca, D.O., FACP
Director of Breast Cancer Program

Views expressed here represent my opinion, not those of GRACE or Banner MD Anderson Cancer Center. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.

August 9, 2016 at 1:59 pm  #1287991    

aya1471

Thanks – is there any evidence about how whether how effective weekly pacitaxol is compared to docetaxol?

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