Taxol: dose dense vs 12 week

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HazelFrances
HazelFrances Member Posts: 70
edited November 2015 in Chemotherapy - Before, During, and After

They gave me a choice between taxol every other week for 4 sessions, or every week for 12 weeks. I think the 12 week version has fewer side effects. Are they equally effective? Does anyone have advice?

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  • Holeinone
    Holeinone Member Posts: 2,478
    edited November 2015

    Hazel,

    I had the 4 dose dense Taxol. ( after A/C ) My MO told me that I would receive more of the chemo that way. After 3 infusions, we discussed stretching out the 4 infusion into 3 separate tx. I had bone pain & was fried from 7 dose dense chemo tx. I also received 7 Neulasta shots. Hard to know how much was due to that or the taxol.

    I was under the impression that the dose dense was the most aggressive way to go. Talk to your MO. See if you get the first dose dense, and it it's too many side effects, you can switch to weekly, for the last 75%.

    I liked getting it over in 2 months instead of 3....

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited November 2015

    My understanding is that dose dense is given at 175mg every two weeks, four times - for a total of 700mg of Taxol.  In studies the people who did dose dense had more allergic reactions, neuropathy, and bone pain than those who had Taxol weekly, but some studies gave more than 4 infusions.  For the weekly dosing my understanding is that 80mg are given, with a total of 960mg for those going 12 weeks - so actually more than those having dose dense infusions, and 640mg if doing 8 weeks. Those doing weekly infusions were more likely to have issues with blood counts, but less allergic reactions, neuropathy, and bone pain.  The downside is that you are being treated longer.  I believe that dose dense sometimes means a continuation of Neulasta/Neupogen - which can mean compounded bone pain for some, whereas lower dose weekly usually does not need the WBC builder.  My understanding is that DFS and OS are statistically comparable regardless of the dosing.  Here is some info:

    http://www.breastcancer.org/research-news/20130612-3

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  • Claire_in_Seattle
    Claire_in_Seattle Member Posts: 4,570
    edited November 2015

    I participated in the clinical trial that tested DD Taxol vs weekly Taxol (as well as DD AC + T vs a constant lower dose). The results were that DD AC was more effective than what is called "metronomic" but that with Taxol they are equally effective. (The study was SWOG 0221 if you want to look up the results.) I was in both dose dense groups.

    I didn't find Taxol, even dose dense, to be that difficult on me. I had Neulasta for immune system support. That is a consideration financially to think about as not always covered and doesn't come cheap.

    Everything being equal, I would go with weekly, provided that I could easily get to the infusion center. But either is equally effective. - Claire

    Edited to add: the link in SpecialK's post is the study I participated in.

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  • muska
    muska Member Posts: 1,195
    edited November 2015

    Hi Hazel, I was offered the same two options: doze dense or 12 weeks and opted for 12 weeks because it does not require Neulasta shots in between and studies show it is no less effective than dose dense, some studies even indicate it is more effective. Even with weekly regimen my dosage had to be reduced from 80 to 70 because of elevated liver enzymes. I had no blood count issues, but had a mild neuropathy that resolved on its own. I was able to work through it but took the infusion days off.

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  • MEG2
    MEG2 Member Posts: 114
    edited November 2015

    Hi Hazel, I did DD...I did have some bone pain but in general tolerated Taxol well. I did the AC+T regimen and did both chemotherapies on the one week on, one week off schedule.

    I liked the idea of finishing in 16 weeks (each drug regimen was 8 weeks) rather than stretching out the Taxol an extra 4 weeks. It worked best with my work schedule as well, I missed just one day every two weeks on infusion day rather than one day every week...that being said it's a personal decision and you should choose what works best for you.

    I also understand that if Taxol is too hard on your body..too many or difficult side effects they can try Taxotere; sort of a cousin to Taxol that has fewer side effects and less chance for neuropathy.

    Best wishes to you during your treatment.

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