Adjuvant chemo after neo w residual disease

Jnnmn7

I met w new MO who offered additional chemo. I did DD AC+ T and had little residual disease after surgery, tumor and micromets in 3 nodes. It would be capecitabine, pill form, for 16 weeks. I am most likely not going to go forward w this because I don't like the idea of putting my body through this. It seems to work better for triple negative. But I am curious if anyone has gone through w this and what their experience was.

Thanks

Mucki1991

I haven't but I'm curious now. Are you young? I'm 43 and wondering why they would add additional chemo after an already aggressive treatment. How many taxol did you do? I start taxol next Friday for 12 weeks.

Jnnmn7

hi. I'm 38. I did dose dense taxol so 4 treatments. It seems to be a newer study.

http://www.nejm.org/doi/full/10.1056/NEJMoa1612645

Like I mentioned, the benefit seemed better for triple negative. My MO had a chart within a lot more study info but I can't find it. She was fine either way w my decision because it was pretty on the fence for my diagnosis

FarAwayToo

Interesting... I'm also doing neoadjuvant chemo for hormone positive, HER2- cancer, I'm 40. I'm just starting, so hoping for a good response, but I've read that HR+ cancers rarely reach complete response. I asked one of the oncs at my clinic, and his answer was that so far the impact of residual disease on survival in HR+ cancers is unclear. Basically, the idea is that anti-hormonal treatment is as important (if not MORE important) in HR+ cancers as chemo.

So, I wonder, is your oncologist offering this concurrently with anti-hormonals or not?

Also, if you don't mind me asking - was node involvement seen before you started treatment? And how large was your tumor at surgery?

Trishyla

I was in the same boat, with residual disease after neoadjuvant ACT and BMX. As you can see from my treatment info, I had both triple negative and Er/PR positive disease. I'm the one who researched and found the Create-X study. My oncologist knew nothing about it and dismissed it, until the results were finally published in the New England journal of medicine. Then she jumped on the bandwagon and said: You need to be on Xeloda!. (She now takes credit for "persuading" me to go on it).

I'm on my 4th cycle (of 8) at 3600 mg per day, and my side effects have been minimal so far. Cracked skin on my thumbs and a couple of days of intestinal issues each cycle. I know others have more severe side effects, but it has been very, very doable for me.

They do say it's more effective for triple negative, but it also works for hormone positive disease. So for me it's a win/win. My personal opinion is that it's worth a try. Throw everything you can at this beast. You can always stop at any time if it gets to be too much.

Good luck!

Trish

Jnnmn7

I am on tamoxifen, would come off that I believe for more chemo. She definitely wants me on hormonal therapy. She actually offered an AI w ovary suppression instead of tamoxifen which I'm on the fence about. This was a second opinion appt and my current MO never offered that.

My original MRI measured the tumor at 4.5 cm w 1 positive lymph node from biopsy. Neoadjuvant chemo did the "Swiss cheese" effect on the tumor and only had very small bits left over and the 3 nodes were micromets so chemo worked really well.

beauz

Hi, everyone. Thank you for sharing. Very valuable information for me here. I am also doing neoadjuvant chemo, half way through my weekly taxol treatment. My oncologist always says his aim for me is to gain maximum margin for my surgery. He checked my tumor during AC treatment, each time he said "no significant changes, at least it is not growing". I could feel that my tumor getting smaller after each treatment, just not as fast as I wanted. He ordered a ct scan for me after my 4th taxol, which showed a significant shrinkage of tumor. My tumor seems to shrink faster during taxol, but it seems still firmly attached to chest wall…I guess I will have a long recovery after the surgery. Also I read somewhere that hormone blockers only effective for er+/pr+ type, not effective for er+ only type. Is it true?

Legomaster225

Beauz, I never had imaging of my tumor during chemo but I could feel it getting softer/smaller. It was still very prominent when I went in for my BMX. I actually had a great response and although the Timor bed stil measured 3.5cm there were very few viable ( I think the pathology report called them rare) cancer cells spattered across 2 mm. My previously biopsies lymph node was also negative at surgery. I remember my MO saying the AC is strong and keeps working even after you stop it. I’m not sure how long that is though. Hopefully you will get continued good response with the next half of your Taxol. Not sure about the HR blockers if you are pr- but one if my tumors was 23ER/10PR and the other was 100/83. I just started on tamixifen and praying it’seffective on whatever is left in my body.

Mucki1991

thanks for the link

AgathaNYC

Hi, Triple Negative here :-)

If there is any residual cancer after my neoadj, surgery and radiation my MO's plan is for me to go on Xeloda. Since no other therapies are available to me that news was a Godsend. (just discussed it for the first time with my MO today.)

I'd be very curious to hear from anyone who has been through a course of Xeloda what it was like vs. the infusion chemo you may have had.

Jnnmn7

https://pdfs.semanticscholar.org/e041/993d9bf2edfc...

Full arti

AgathaNYC

thank you for the above link.