tac or dose dense for trip neg

Dear Staci - I went with dose dense AC followed by modified rad mastectomy then dose dense taxol, then 6 1/2 weeks radiation. I am 6 yrs out from diagnosis!!!!! Best of luck to you! Dunner

Staci

I did the TAC regiment.  You actually get 6 doses of all 3 instead of 4.  The difference is that usually they are 3 weeks apart instead of 2.  The side effects are comparable because you are getting 3 drugs instead of 2 at a time.  The research is pretty much the same for both regiments so choose the one that works best for you.  I had kids at home and was glad to have 3 weeks between treatments so I could feel well enough to attend some of their events.  I am now 4 years out and everything is still looking good so far (keeping fingers crossed)

Jackie

The gold standard is DD (the cells don't have time to take hold between treatments).

Buy, the newest recc is DD ACX4 plus 12 weekly taxols.  Seems like with TN disease the frequency of chemo is as important as dose:

Comment on:

J Clin Oncol. 2008 Mar 10;26(8):1275-81.

Dose-dense and/or metronomic schedules of specific chemotherapies consolidate the chemosensitivity of triple-negative breast cancer: a step toward reversing triple-negative paradox.

I am going on my 3rd round of dd AC next week. After that the plan is 4 rounds of dd Taxotere. I asked my onc. about doing the 12 weekly Taxols and she said that 12 weekly Taxols was equivilant to the dd taxotere. Does anyone else have any info about this? I obviously would rather just have 4 rounds than 12, but also want to make the best decision for long term health.

Melissa~ Go to the link for nosurrender in my above post.  Edge explains it better than I can.  I talked to my onc about it to and his reply was 1. DD and weekly likely have similar outcomes. 2.  Weekly *may* be slightly better but there haven't been any studies specifically comparing those group.s. 3. Weekly taxol is easier to tolerate (and I had a really hard time with AC so easier is better).

Whatever you chose... don't look back.  I'm sure it will be the right decision.

Michele

I am going for a consult with one of the top TN research oncologists on Thursday.  I will let you know what he tells me...

I just finished 6 TAC - my oncologist chose TAC every 3 weeks for the reasons given by others above.  It was not too bad for me at all -- I actually worked through my treatment except for day of and day after (and then the weekend).  My treatment was neoadjuvant - which is common with triple neg.  My dx was locally advanced, stage 3 with some some node involvement.  My nodes have disappeared (one wasa 2.5cm) -- as has almost all of my tumor (15cm - of which about 6 was removed for excisional biopsy).  The oncologist says he doesn't know what they will find after surgery the mastectomy -- e.g., what little he can feel may be scar tissue from the biopsy, there may be some residual disease, there may be necrotic tissue -- but TAC seems to have beaten back the beast.  As for Taxotere v. Taxol - my onc says the SEs of taxotere are less severe (particularly the possibility of neuropathy) -- and for that reason, it is his chemical of choice. 

I had abraxane, epirubicin and cytoxin the first week, followed by abraxane only the 2nd and 3rd weeks, with 4th week off neoadjuvant.  My white counts dropped way low and I got pneumonia.  I couldn't finish the regimen.  My post surgery staging is IIIC ILC, TN.  I don't know the grade, but since I'm getting avastin, I know it's developed the abililty to make it's own blood supply.  Seems like on these boards everyone thinks being her2+ is better.  My onc says her2+ is less predictable than TN, that's he's had her2+ patients in early stage suddenly go to mets.  What are you all being told by your oncs?  At mast. I had pieces of tumor in every quadrant of my breast, surrounded by lots of dead cells due to chemo, 27/29 positive nodes.  We're now hitting the chemo hard again, but this time abraxane, gemsam and avastin, every week for 3 weeks, 1 week off for the next six months.  Since I just started this regimen, I don't know yet how I'll tolerate it.  Been thinking about going to MD Anderson to Dr. Christofannelli for a second opinion.  Any comments anyone?   

Staci~ Are you going with DD taxol or the 12 weekly when you get there? Just curious...

Also, do you have Zofran or Emend for the nausea?  That might help you a lot.

good luck!

Michele

I'm finding out any kind of breast cancer can be unpredictable.  See the girls on the mets site.  Some had early disease of any kind and still have recurrences and than I meet girls that had very involved nodes and never have a recurrences.  My oncologist says it is the luck of the draw.  Each of our bodies are different and respond to treatment differently.  Also remember TN disease is not the same for us all.  This is just a generic word for bc that they can't find the receptors for. I've learn we are each individuals and watching someone else's treatment plan really does not mean a lot.  The questions is how your body responded to the tx you had.

I've been watching TN treatment for almost four years now.  There still is not any set protocol for TN.  Doctor's are moving and trying new things with us but right now they just don't know what is best.  The oncologists I've meet said it will take about five years to see how they are doing. 

MD Anderson is not treating TN ladies any different than other places in the country.  Actually they are still playing with old drug combos.  I would do my research for local oncologist who has access to new drug and will read the latest studies. Since there are no new chemo's your local doctors can tx the same as MDA.  Everything new is not about chemo but about protein and enzymes inhibitors for the future tx of TN.  Right now they are only in very small trials for stageIV bc.

Flalady

Thanks again for the great info guys.

Hi Gayle,

You should start feeling better tomorrow or the next day. I  typically felt icky my 2nd and 3rd days after A/C tx- same side effects as you are having: nausea, headaches, dizziness, lack of appetite, icky taste in my mouth.

Unfortunately, for some, it does seem to compound and each tx can get a little worse, but still manageable. This was the case for me.  I lost my hair after my 2nd DD tx of A/C - about day 19 I think. On the bright side, Taxol as a piece of cake compared to A/C in my opinion. No nausea, just some minor bone pain in my legs at night. Hang in there sweetie.

Raye

Hi Gayle,

I had Taxotere not Taxol, but the two are very similar. My chemo experience was much like Raye's. I thought the Taxotere was much easier to take than A/C. Also, I usually felt fine the day of tx. With A/C I started feeling cruddy toward the evening of the second day after tx. With Taxotere, I didn't start feeling bad until the third day after tx. Mostly, I had headaches and bone pain. It's unpleasant, but really very doable. The time goes by more quickly than you might think and you will be glad you  did it once it's over.  Hang in there!

 Cherie

Saja,

I had dose dense AC in the neoadjuvant setting (prior to surgery)  it was 4 rounds biweekly.  I then had a 6 week healing time before bilateral mastectomy on dec 1, then had port placement surgery dec 23 and ended up in hospital for complication.  I then started 2nd round of chemo with Taxotere 4 rounds at 3 week intervals.  It seems to be a good protocal - my oncologist doesn't lkek to do the ACT becuase it is so much harder on the body. Just started 30 rounds of radiation...

Melissa, I cannot have the A part of A/C because of health  problems so I am getting 2 extra round of Cytoxan.. Nothing else he could do. I don't know if there is any research on the topic or not. I have been told that the A part is the worse as far as side effects. I wish I could have taken it and hit this cancer with all that is available.