TAC v. TC clinical trial

ptjen

While trying to find info on TC 4x or 6x, I learned (on this discussion board) that some women are getting 4x and some 6x.  Not that I want 6 but I am on TC 4x after rejecting AC/T dose-dense but am concerned about undertreatment. My onco says there aren't any studies on it and she stays with the studies. I love her and she has proven her judgement to me several times, but on this one, I want more info. I learned that there is a Phase III study of TAC v. TC (both 6X, I believe) currently recruiting participants (ClinicalTrials.gov identifier: NCT00493870), but b/c of my "mushy middles" I was never a candidate for a study and I don't want the A in the TAC anyway and I've already had two of four tx.  But I want to determine if 6x would provide additional benefit over the 4x. Has anyone learned if any info has come out of the Phase II trial regarding how the TC 6x is working? I plan to ask my onco to see if she will get info, but I've found this forum to be so helpful, I wanted to put the question out there for additional ammo. Pat

Dx 9/2008, IDC, 3cm, Stage II, Grade 3, 0/1 nodes, ER+/PR+, HER2-

GryffinSong

I don't know, but am glad you've asked. I've been offered the TAC/TC x 6 trial, or TAC x 6, or the dose dense thingy. I'm having trouble deciding what to do.

dlb823

Hi, Pat ~  Your question is a good one.  The 4 vs. 6 question has been brought up several times on the TC board ("Anyone On Just Taxotere & Cytoxan?")  I did 4 TC's, and when the question arose amongst us on that board back in September, I asked my onc @ UCLA if there was any justification for 4. She told me then that the data was based on 4, and that there was no evidence that 6 was better.  However, I've recently chatted via PM's with another gal here who has the same onc, and she's getting 6.  She's younger than I am (I'm post menopausal), and she had multiple positive nodes, so I'm guessing that's why our onc felt she would be safer with 6. 

I believe that trial has just gotten underway, so think it's too early for any data from it.  But, like you, I am watching and listening for any update -- not that I would go back and do more, but just hoping to continue to feel safe with what I did.   Take care ~   Deanna 

ptjen

Hi GriffinSong: If you're interested, I have alot of info on A and I was sent a link to a UCLA online video that I saw after I decided not to have the A - but am really glad I saw it b/c it confirmed my decision. Let me know if you want the link.

 Hi Deanna: I followed that discussion and decided to pull it out and give it it's own forum. I know there's no published info on the Phase III since they are currently recruiting, but something took place during Phases I and II that made them decide to go forward with Phase III - and I want that information. There are contacts listed, but I know I should ask my onco to make any contact that needs to be made. I have found a couple of journal articles abstracts that might be related and will check the journals for the full articles to make sure I'm dealing with the correct study. Thanks, Ladies!

lisalisa

Hi pjten - is there a link to the ucla video?  I'd love to see it!

I'm the one that Deanna talks about in her post.  I see the same oncologist as she does.  I was asked to be part of that study, but didn't want to chance taking A.  So, I'm doing 6 cycles of TC.

I'm 45.  I had 6 positive lymph nodes.  I also have 2 young kids (ages 9 and 5) and told my onc that I want to be aggressive....I have a lot to live for!  (as we all do!)

This thread is interesting and I'll be watching for more posts.

 p.s. what do you mean by "mushie middles" not qualifying you for a study?  what is a "mushie middle"?

CindaD

This is a very interesting topic, I'm also 45 but just getting TCx4, nodes were clean and my tumor was smaller, however it was a grade 3, so now I'm asking my onc about the 4 vs 6 next time I see him.  I want to blast the cancer out of my body and never look back!

rumoret

Looking for the Optimal Treatment Schedule for Taxanes

While a group of chemotherapy drugs known as taxanes have an established role in breast cancer treatment after surgery, new studies investigating the optimal schedule have produced conflicting results.

The phase III NSABP B-30 trial, which compared three schedules and combinations in women with node-positive breast cancer, found that

Adriamycin (doxorubicin)/Cytoxan (cyclophosphamide) for four cycles followed by the taxane Taxotere (docetaxel) for four cycles (known as a sequential schedule) decreased mortality by 14 percent

compared with Taxotere/Adriamycin/Cytoxan given concurrently for four cycles, and by 17 percent compared with Adriamycin/Taxotere without Cytoxan.

Researchers found that the Adriamycin/Taxotere regimen was as effective as Taxotere/Adriamycin/Cytoxan with regard to overall survival. In terms of disease-free survival, the eight-cycle sequential schedule had an even stronger advantage over the other two regimens.

Another phase III trial, BCIRG 005, compared Adriamycin/Cytoxan for four cycles followed by Taxotere for four cycle

with Taxotere/Adriamycin/Cytoxan for six cycles in women with HER2-negative, node-positive, early-stage breast cancer. The two regimens were equally effective with regard to disease-free survival.

Taxotere/Adriamycin/Cytoxan was given for the more conventional six cycles to patients in BCIRG 005, whereas the NSABP B-30 trial used four cycles, so investigators commented that patients on Taxotere/Adriamycin/Cytoxan in NSABP B-30 may have been undertreated, and a direct comparative trial of the conventional six cycles of concurrent therapy versus sequential therapy is ongoing.

CURExtra - Winter 2009 - article 

ptjen

 http://www.simmsmanncenter.ucla.edu/Hi LisaLisa: The above was actually sent to me by Deanna. "Once on that page, click on Current Resouces (at left) and go to Archives/Insights Into Cancer Videos (at right)" and select the video by Sara Hurvitz. It's really interesting. Also, I think I misspelled "mushy middles" -  it the name for being in the gray areas that make our decisions for treatment so difficult and were also the ones that the clinical trials don't want and don't test for. They want black and white and were gray. Do a search for mushy middles on this forum board and you'll see. Rumoret: Thanks for the info. I'll check it out. CindaD: I know exactly what you mean! Blast it so it never dares come back! 

ptjen

I just found a brief podcast of an interview with Dr. Joyce O'Shaughnessy regarding the TAC v. TC trial and TC chemo in general. Use this link and scroll down:  

http://www.breastcancerupdate.com/download-audio/bcu/2008/2/default.asp#5 

cfer

I am 39 and like some others on this page, I'm trying to decide between some version of AC+T and TC (four cycles). Because TC is both shorter and potentially less toxic, it's obviously appealing. However, I'm concerned that perhaps the TC approach is not aggressive enough given my age and the grade of the tumor (3). Since there are no complete studies that compare these two chemo regimes, how should one decide?

Sharon648

The 4 vs. 6 question ?I am facing the same problem..I just finished my 4th TC and my oconlogist told me that no much different doing 4 or 6 only 5% doing six..So i am still deciding why i want another 2 more .I am 53 stage 2a..had not spread to any nodes..grade 3..i hope to get some answer to this..before my 5th chemo on aug 10th..

haehae

sharon648: I just posted the same question on the apr/ may TC thread. See dancetrancers reply. What did you decide to do?

Runnergirl36

I got 2 opinions when i was deciding what to do. One ONC said TAC and one said TC (both 6 cycles) after much research i went with the TC. (had my second one yesterday)