stick with docetaxol or switch to weekly pacitaxol - 1287956


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??





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.


Posts: 2753

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."

Forum moderator

dr cianfrocca
Posts: 49

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

Posts: 7

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