Choosing between AC-THP and TCHP

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frankiesf
frankiesf Member Posts: 9
edited October 2017 in Chemotherapy - Before, During, and After

I was just diagnosed with stage 3A invasive ductal carcinoma with the following characteristics:

grade 2 (T3N1M0)

ER+70% / PR+3% / HER2 3+

Ki67 30% overall

Mamaprint: high risk

I've been given two options for neoadjuvant systemic therapy prior to surgery: AC-THP or TCHP. I am 48 years old, in very good health aside from this recent diagnosis. My heart is in good shape. I am weighing the risks and benefits to both of these chemotherapy regimens. I'm looking for information from anyone who was faced with the same decision. Which did you choose and why? Did it work? What side effects did you experience?

I've also been offered the option to participate in an I-SPY trial that would randomize my therapy to either AC-THP or ACTH + patritumumab. My oncologist didn't seem to think this was a good option for me, so I'm not really considering that. If you have any experience with this arm of the I-SPY trial, I'd also be interested to learn about your experience.

Thank you.

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  • Moderators
    Moderators Member Posts: 25,912
    edited October 2017

    Hi frankiesf,

    We don't have any advice for you on this, however we wanted to drop by to welcome you to Breastcancer.org! We're so sorry you have to be here, but we're really glad you found us. You're sure to find great support and information here. Others will likely be by shortly to weigh in with their thoughts and experiences.

    We look forward to hearing more from you soon!

    --The Mods

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  • rljes
    rljes Member Posts: 547
    edited October 2017

    Frankiesf - Hi! My dx is similar to yours.  I was not given a choice.  I had a BMX, and in NOV will be taking Taxotexe/carboplatin/Herceptin/  

    Just curious what you ended up taking.  It seems that most that take AC are HER2-

    Wish you well,

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  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited October 2017

    My MO told me about both options, but he felt that the very slight edge that the AC might give me wasn't worth the potential heart issues and risk of leukemia.

    I was told that I had a 65% chance of having pCR - and I did! No cancer was seen by imaging after NAC and none was found by surgical pathology.

    The SE's were many, but I suppose that's true for any chemo. Sometimes I feel it's a little like childbirth - you forget exactly how it was. The important thing for me is that I made it through and don't seem to have any lasting problems.

    Feel free to PM me if needed.


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  • stephaniebc
    stephaniebc Member Posts: 53
    edited October 2017

    i wasn't given a choice: AC-THP. i am sure both regimens have their downsides. with this one the downside is definitely the AC, but then weekly taxol is relatively easy, and i believe less toxic than taxotere.

    i had a PCR and it happened almost entirely with the first infusion of THP. the tumor literally melted overnight.

    it had shrunk by 20% with AC.

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  • frankiesf
    frankiesf Member Posts: 9
    edited October 2017

    Thank you everyone for sharing your thoughts and experiences. Though I feel fortunate to have options for my treatment, I don't feel particularly well equipped to make the best decision. It seems there are risks and benefits to both regimens, I'm just not sure which offers a better option for my particular cancer. I am seeing my MO today and will discuss with her. I am also seeking a second opinion at a very well-respected medical institute, so hopefully the answer will become clearer soon. Again, I appreciate your support, it means a lot. (and wow, I had to look up almost all of the abbreviations in your messages—I'm a novice in this world and I still can't quite keep all of the tests and markers and drugs straight).

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