Taxotere now - maybe Abraxane next? - 1250992

kate0228
Posts:36

Hello,
Stage IV NCSLC, adeno with no mets. Husband was on Tarceva for 7 months until slight progression. Carbo/Alimta for 4 rounds then alimta alone for 1 round until slight progression. Took a 2 month break. Had 2 treatements of Taxotere and not tolerating it well. Usually crashes on days 7-11 and is literally in bed all of those days. After day 11, starts to bounce back then has good days until next treatment. Today is day 11 - feels better but feet are both painful and numb in some areas. Scan is Monday. Dr. mentioned possibly switching to Abraxane. I've read a little on this and by reading Dr. West's comments, I'm a little leary. Dr. Walko seems to have used this alot? Any new or additional comments anyone would like to add about Abraxane? Also, does the side effects for my husband, Tony sound normal or excessive? If the scan shows improvement, would they keep him on Taxotere if he is struggling so much? I'm concerned about neuropathy. How much is too much?

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Reply # - December 6, 2012, 10:59 AM

catdander
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Let me try this again. I just lost everything I just wrote, akk!

Kate, I'm so sorry your husband is experiencing peripheral neuropathy (pain and numbness in hands and or feet). Unfortunately it's a common side effect of the taxanes, chemo drugs including, taxotere, taxol, and abraxane. The best treatment for this side effect is to take away the offending drug. Abraxane is taxol in another form, and while some of it's side effects are remedied by this change the peripheral neuropathy remains.

So like you have read Dr. West doesn't move from one taxane to another when the patient is experiencing peripheral neuropathy. I'm not sure of Dr. Walko's discussions about the taxanes but she doesn't take patients instead she works with oncologists as a pharmacist who specializes in oncology. So while she knows more than most oncs about the make up and interactions and side effects of these drugs she doesn't prescribe them.

Do I understand that your husband is EGFR mutation positive. It sounds like his first line was tarceva. If that's so is it possible he was taken off that treatment too soon with only slight progression. Here is a blog post on the fast moving subject, http://cancergrace.org/lung/2012/08/05/acquired-resistance-faq/

If he hasn't been tested for the mutations that is an option. A trial may also be an option. Also a second opinion with a nsclc specialist may be in order. This blog post describes the many reasons why 2nd opinions are a good idea, http://cancergrace.org/cancer-101/2011/11/13/an-insider’s-guide-to-the-second-opinion/

I'll contact a doctor for input after you've had a chance to read over this blog posts and we've received your follow up questions.

Janine
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Reply # - December 6, 2012, 11:16 AM

kate0228
Posts: 36

Long story short...They were never able to get a good biopsy for mutation from day one. We go to MDAnderson in Houston and Dr. Fossella put him on Tarceva as first line. We also consult with our local onc here in Louisville KY. Tony had a small pleural effusion that they (Louisville) drained and they did test it for ALK. It was neg. Didn't test for EGFR but said he saved enough to test in case we need it down the line. I've felt from day one that they pulled him from Tarceva too quickly, but who am I to question?! I would love to look into a trial. MDA wanted to try BATTLE 2 but Tony didn't have anything they could biopsy. They wouldn't accept bronch wash - wanted core biopsy. All of his cancer is GGO. I'm looking at maybe something closer to home at Vanderbilt. Would love to do something that involves Tarceva plus something to go with it. Life is all about choices isn't it?!

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