TAC v. TC clinical trial

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 

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"?

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 

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..

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)