Weekly Taxol/Herceptin?

undecided8

Weekly Taxol/Herceptin?

undecided8

My oncologist will be doing my regimen on a weekly  basis instead of every 3 wks. Has anyone else done this before? He tells me it's because of a new clinical study. I'm just about done with my A/C tx. thanks!

Annaanne

Hi. I had taxotere, which is pretty similiar and asked for it weekly, rather than every 3 weeks...I'd heard it was easier on counts, etc. I've since read that weekly might be slightly more effective.

There was a down side, however. I had a hard time with the pre med steroids, and if you have a weekly infusion, you will most likely have premeds every week instead of every 3 weeks.

Hope that's helpful.

Take care

Annaanne

Diana63

I am on weekly Taxol, I have two more treatments left. I have heard and read that it easier on you system, and that it may have benefits for high risk people. I dont know if its easier or not because its what I have been on, but it is easier than AC.

You can google it and get a lot of reports on weekly dense dose treatment's.

Diana63

Here is one that I found but their are many more to read about. 

http://www.cancer.gov/clinicaltrials/results/dose-dense0604

Dose-Dense Chemotherapy Helped Patients with Metastatic Breast Cancer

Key words

Metastatic breast cancer, dose-dense chemotherapy, paclitaxel (Taxol®), trastuzumab (Herceptin®). (Definitions of many terms related to cancer can be found in the Cancer.gov Dictionary.)

Summary

Weekly administration of the drug paclitaxel (Taxol®) to patients with breast cancer that had spread to other parts of the body resulted in a higher response rate and a longer delay until patients' disease progressed, compared with conventional administration of the drug every three weeks. The same study found no benefit from adding the drug trastuzumab (Herceptin®) to paclitaxel for women with metastatic breast cancer whose tumors do not overproduce a protein called HER2.

Source

American Society of Clinical Oncology annual meeting, New Orleans, June 5, 2004. Final results subsequently published in the April 1, 2008, Journal of Clinical Oncology (see the journal abstract).
(J Clin Oncol. 2008 Apr 1;26(10):1642-9)

Background

Conventional cancer chemotherapy is given at three-week intervals. In recent years, however, some researchers have begun to investigate "dose-dense" drug regimens where chemotherapy drugs are given more frequently, such as once a week or once every two weeks. The drug dose is either kept the same or is lowered slightly. The idea is that exposing cancer cells to the drugs more frequently may kill more cells and thus improve the effectiveness of chemotherapy.

Previous studies have suggested that giving the drug paclitaxel (Taxol) at weekly intervals might decrease side effects while improving outcomes for women with breast cancer that has spread (metastasized) to other parts of the body.

Studies have also shown that the drug trastuzumab (Herceptin), in combination with paclitaxel, improves response rates in patients with metastatic breast cancer whose tumors overexpress (make too much of) a protein called HER2. About 25 percent of breast tumors are HER2-positive. These tumors tend to grow faster than other tumors. Trastuzumab targets the cancer cells that overexpress HER2 and slows or stops their growth.

The Study

The main goals of the study (called CALGB 9840) were to find out (1) whether more patients would respond to treatment with weekly paclitaxel than to the standard paclitaxel regimen, and (2) whether the addition of trastuzumab to paclitaxel would improve response rates in patients whose tumors did not overexpress HER2.

A total of 585 patients were enrolled. When the trial began, patients were randomly assigned to receive either weekly paclitaxel or the standard paclitaxel regimen. While the trial was underway, trastuzumab became accepted as standard therapy for patients with HER2-positive tumors. From then on, all patients with HER2-positive tumors received trastuzumab in addition to paclitaxel. Other patients were randomly assigned to receive either paclitaxel alone or trastuzumab in addition to paclitaxel.

This study was conducted by the Cancer and Leukemia Group B (CALGB), one of several cooperative groups funded by the National Cancer Institute to conduct large cancer clinical trials. The principal investigator was Andrew Seidman, M.D., of Memorial Sloan-Kettering Cancer Center in New York. (See the protocol summary.)

Results

When the researchers calculated the study's results, they included an additional 158 patients who had been treated with the conventional three-weekly paclitaxel regimen in another CALGB study. This brought the total number of patients included in the calculation of results to 743.

Forty percent of patients treated with weekly paclitaxel responded to treatment, compared with 28 percent of those who received the standard regimen. Patients in the weekly paclitaxel group lived for nine months on average before their disease progressed. In patients receiving the standard paclitaxel regimen, by contrast, disease progressed after five months.

Among patients treated with weekly paclitaxel, there were more nervous-system side effects but fewer instances of low blood counts.

For patients with tumors that did not overproduce the HER2 protein, additional treatment with trastuzumab did not improve the response rate, a finding consistent with previous studies.

Comment

By design, the trial included in its final analysis 158 patients from another trial. These patients had received treatment similar to that given to patients who had been randomly assigned to the standard paclitaxel arm of the trial discussed here. However, some physicians at the ASCO presentation questioned whether the inclusion of patients from another trial might not have biased the final result.

Anonymous

Undecided, I finished Dose Dense AC and 12 weekly Taxol/Herceptin treatments. The AC was much more physically uncomfortable for me.

Taxol was great until about week 8. Fatigue started to get to me, and leg/foot/ankle swelling got progressively worse. I finished up a bit over a week ago ... legs still swollen and sore, but that's about all that's left of Taxol side effects. 

oldcat46

Hi.  I had A/C X 4, then Herceptin and Taxol x 4.  The Taxol was given every 3 wks, the Herceptin every week (stilll getting that).  I didn't ask about having Taxol every wk.  I also didn't ask why I was given Herceptin each wk instead of every 3 wks.   I think having Taxol every 3 wks may have been easier on me although my red count dropped at first and I needed Arenesp. 

Now I read in places that Taxol each wk is more effective.  Also, it seems Herceptin is better each wk.  But it's different with different doctors and these were two of the questions I didn't have written on my list of about 700 when I asked my onc about everything. 

"Undecided," just try to keep up with the clinical study findings and base your decision on what your doctor advises, what you learn from investigation and on the board, and your own common sense and answer to prayer.  Everything changes over the months and years anyway, and what was the best at one time won't be later. 

mimi1030

My mom is on weekly Taxol/Herceptin and monthly Zometa for her bones.  She has no side effects at all, she couldn't ask for a better chemo, especially since she will be on it indefinitely.  My mom did A/C back in 2004 when she was dx with stage 1 and it kept her in the isolation ward in the hospital for the most part, she would never go back to having treatments every 3 weeks, it is too hard on her blood and her body.  She doesn't miss a beat with this treatment, she goes about and does her everyday things as normal, exercises etc.  She does well.