Will more than 6 Taxotere treatments extend length of stability?

Portal Forums Cancer Treatments / Symptom Management Conventional Chemotherapy Will more than 6 Taxotere treatments extend length of stability?

This topic contains 2 replies, has 3 voices, and was last updated by Dr West Dr West 2 years, 10 months ago.

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January 4, 2015 at 11:07 pm  #1267822    

ismania

In October 2013, I was dx stage 4 adeno nsclc – 1 primary tumor (3 cm) in right lung middle lobe spreading to lower lobe, one small nodule, cancer in my chest wall, lymph nodes, malignant pleural effusion, and mets to my diaphragm. Did a VATS surgery but given what the doc saw, he decided against removing any portion of my lung. 4 rounds Alimata/Cisplatin, 2 rounds Alimta maintenance and tumor shrunk 50%, nodule disappeared, and all pleural effusion under control…took short break in order to visit my family half way across the world and cancer came back with a vengeance…put on Tarceva for 1 month only to have cancer spread even more…now have a second tumor (3m) in my pleural and mets to the bones (3 ribs)…have completed 6 rounds of Taxotere. Seemingly great results after first 3 treatments based on x-rays and last 3 treatments have show stability with marginal improvement…Onc has suggested that if I’m feeling okay we should try for 7 or 8 treatments as a way to extend the life of my stability given that he believes I can never become NED. Of course, the trade-off is the long-term effects from all this toxicity. What I’m wondering is what the statistics are for those who do 7 or 8 treatments rather than just the usual 6 treatments of Tax. Will those extra treatments substantially increase the potential length of stability for me?

P.S. reason for not doing CT scan at this point is that I don’t have health insurance and am running out of my savings. Onc and I both believe that the x-rays do show us something and that we’ll wait til after round 6 or 7 or 8 of Tax before doing a CT scan.

January 5, 2015 at 4:08 am  #1267826    
JimC Forum Moderator
JimC Forum Moderator

Hi ismania,

Welcome to GRACE. I’m glad that you have found a drug that has provided good results for you. There’s really no way to know how much benefit you would get from a couple more rounds of Taxotere; it’s similar to the question of whether “continuation maintenance” (continuing with a chemo drug indefinitely after achieving stability) actually helps. It’s not clear whether it’s the continued treatment that is providing stability, or that your cancer would be stable anyway. Unfortunately the only way to determine the continued value of a chemo regimen is to stop it and see what happens.

Taxotere is a challenging treatment for many patients, and for that reason is not usually administered longitudinally. And as you point out, there is a cumulative effect on bone marrow function that can result in difficulty tolerating future treatments.

I wish there was a more definitive answer for you.

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 5, 2015 at 10:13 pm  #1267844    
Dr West
Dr West

Taxotere is theoretically given in the second line and later setting until progression. There aren’t really detailed stats on how much the progression-free survival is prolonged by treating beyond 6 cycles. Many patients progress before then, and without a CT to assess results recently, you’re essentially treating blind. X-rays are arguably better than nothing, but not much better. We don’t want people to continue on a potentially toxic therapy beyond the point at which their cancer is progressing, and it’s therefore important to be able to actually assess what the treatment is doing over time.

Good luck.

-Dr. West

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