paclitaxel/carboplatin: whether to complete 6 cycles or to stop at 5 cycles? - 1247031

ivy5
Posts:1

I have endometrial cancer, stage IIIC, type 2. I've completed 5 cycles of paclitaxel/carboplatin at the maximum dose level (carboplatin 600 mg and paclitaxel 340mg). After 5th cycle peripheral neuropathy has set in with numb toes. Podiatrist warns not to expect improvement in toes; recommends lifetime Cymbalta. Can anyone quantify what is added benefit in cancer prognosis if continuing with cycle 6? I'm very worried about increased neuropathy in feet and new problems that might present in hands, hearing, and vision. Trying to find a way to balance these competing factors. Any relevant data would be appreciated.

Thanks!

Forums
Full Archive

Reply # - August 19, 2012, 10:27 AM

catdander
Posts:

Hello Ivy, I'm very sorry but Grace does not provide information specific to endometrial cancer. However Dr. West has much experience the the drug combination you're on because it's also given in nsclc. Perhaps he will be able to shed light on your question.
All best,
Janine
forum moderator

Reply # - August 19, 2012, 07:10 PM

Dr West
Posts: 4735

I don't think the issue is one that is very specific to endometrial cancer. The problem is that it's really a judgment...how bad is the neuropathy? how disruptive is it to a person's life? But to try to address the question of how much of an incremental benefit the sixth cycle adds beyond the first five, the best answer is "not very much". The benefit is definitely front-loaded, so that the first 3-4 cycles provide the vast majority of the benefit, and you do reach a point of diminishing returns. Because of that, I think many and probably most oncologists would favor stopping after five cycles in someone experiencing a lot of neuropathy. That said, I don't think there's any actual evidence to suggest a percentage of benefit you lose or gain...I'd just estimate it to be perhaps 5% of the total effect, if even that. So with more treatment you experience greater cumulative toxicity and less incremental benefit compared to prior cycles.

-Dr. West

Previous PostNext Post