completed 6 rounds Carboplatin/Taxol/Avastin - need advice - 1272714

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completed 6 rounds Carboplatin/Taxol/Avastin - need advice - 1272714

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?

Hi Good-life,

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.

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<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

If asking whether to continue

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: