Overreaction to Taxotere -- Alternatives?
Last Friday I had my first infusion scheduled for 4 rounds of taxotere and cytoxan. I was prepped with a steroid (pills) and an antinausea in IV. A few minutes after the taxotere started, I reacted badly. I flushed and got very hot, my heart rate and BP rose. (Ultimately I saw my BP systolic at 174.)
Nurses appeared from nowhere, stopped the drip, pushed benadryl, gave me oxygen so my chest could relax again. After my vitals improved sufficiently and we waited 30 more minutes, they tried again with a slower infusion rate. The pharmacist was right there the whole time. She assured my husband that it is very rare to react a second time. But I did, sooner than the first though less dramatically.
My MO was contacted of course and he said to stop and send me home. (This was disappointing and frustrating but also a relief.)
Tuesday I'll meet with MO about what to do next. Anyone have experience with this? What are solutions or alternatives? I assume one possibility is prepping me with more steroids in the days before infusion. What about alternative chemicals? Abraxane or others?
Thanks in advance.
Comments
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bumping this to try to get some eyes and comments on it. Anyone?
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What about Taxol? It's meant to be less harsh although basically the same drug. I had bad reaction to Taxol and they gave me Taxotere instead which I tolerated.
So it does make a difference. Good luck.
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Thanks, trinigirl. I'm hoping there is a "simple" swap that will work.
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Hi Mountain mia Hello from the UK.
Only just found your post about your reaction to taxotere. I too had a reaction to pertuzumab and taxotere on chemo cycle 1 four weeks ago. Not same reaction as you - i got muscle cramps and low blood pressure, and ended up with a two night hospital stay. I was substituted Abraxane for taxotere and cycle I was fine, what a relief. My infusions were done over two days with Abraxane on day 1, then Herceptin and pertuzumab on day 2. Next cycle the plan is for all three infusions on one day. nearly forgot to say i was also given additional preventative drugs piriton (antihistamine) plus one other (sorry drug name not known) in addition to steroids. After my initial adverse experience i was so worried that i wouldn't tolerate chemo but was assured by senior medic that there is always an alternative plan of action available. I'm sure there will be a regime that will suit you, plain standard protocol is not right for all, trust your oncologist's knowledge. Wishing you a smoother path ahead. How was cycle 2? Alice
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Thanks for the information, Alice. I'm glad it worked out for you. I haven't managed a first cycle yet. I'll find out Tuesday what the alternative ideas are.
THANKS again!
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I wouldn't try it again, mo should look at other drug options for you. Someone mentioned taxol, perhaps CMF treatment.
Hope you have recovered.
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Thanks, Meow13. I expect he has some options to present. I hope!
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That was me too. Taxotere could not be tried again, as they suspected a possible seizure (turned out not to be), two weeks later we tried taxol and I had all the reactions again. Finally, abraxane was approved, which is a cousin drug but delivered using albumin (human protein), rather than a chemical. I did 5 months without major issues (just flushing, appetite and mild neuropathy). Definitely ask about it.
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illimae, thanks so much for the info. I'm glad you were able to go on with the Abraxane. I'll be sure to ask.
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mountainmia, you’re welcome. Your insurance company may/may not approve it without taxol being tried first, that’s what happened to me. I understand the cost is significantly higher.
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I also had a bad/dangerous reaction to Taxotere, but mine was on my last (of four) cycles. I did better on AC and Xeloda, honestly. There are many chemo options out there. My thinking is that there's no reason to do a chemo that might hurt you unnecessarily, and we all respond differently to these drugs. Best wishes and let us know how it turns out.
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Thanks, buttonsmachine. I will update this after I've spoken with the doctor, for sure!
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I had the same experience six weeks ago when I did my second round. I was just chatting with my nurse and was expecting nothing because nothing happened the first time. Then she looked at me with concern just as I stopped mid-sentence and said "Wow, I'm getting really hot" She immediately pulled the plug. It was as if my head had been placed in a furnace turned on full blast. Even my eyes were hot. Nothing from the neck down, but extremely scary! Then I began to feel all kinds of sinus pressure and felt like my ears were going to pop. An announcement was made that I vaguely heard as a "code in chair 3" and doctors and nurses appeared, rather calmly, checking my vitals. After a few minutes the feeling went away. My doctor who was not there, phoned in and told me that if I wanted to, I could call it a day, or get a cocktail of benedryl and steroids and try again. I looked at my son who had come with me. He had been very calm through all this. He said maybe I should just try it again since I was there already and want to get this over with in time for the upcoming wedding of my daughter in June. So I agreed to it, but I was absolutely terrified. They gave me the cocktail, then tried again with the nurse monitoring. After 15 minutes I began to calm down as it was working. Flash forward 3 weeks, that's how we also proceeded before my 3rd round. Again, uneventful. However, my side effects seemed to be much worse this time especially with fatigue and nausea. Here is the thing - no one can explain these reactions or why certain people get them. Why didn't I get it the first time? You would think the introduction of this stuff to the body would set that off right away. Why the second time? This makes me extremely frustrated as I always want answers to my questions. And with breast cancer, the only people that can tell you are other people who have had breast cancer!
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MarTar, you sound like me!! I want to know why! And of course, what's next? I'm glad you were able to finish that round and the third. You still have the 4th to do? This week or so? Best wishes to you, and to your daughter as she gets married.
Thanks so much.
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Just to update, I met with MO on Tuesday. He said the reaction to taxotere is not like an allergic reaction, like an allergy to dogs or shellfish. If you're allergic like that, you'll react every time you're exposed. My reaction is not a predictable thing. Most people won't react at all. Some will once, few will twice.
I'll try again with the same protocol on Friday. However he prescribed decadron (steroid) to take today, tomorrow, and Friday morning before infusion. This should help my body be less inclined to react. If this doesn't work, he said we'll switch to AC with taxol, and if the taxol is still a problem, go to Abraxane. I'd love it to not be trial and error but I understand that's just the way the process works.
I'm ready to try again. I think this is a good plan, given the circumstances.
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Good luck! 😀 May your next infusion be uneventful.
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MountainMia
Sorry to hear about this. Scary stuff. I understand a bit...
I had to have Piriton in the drip before the infusion and a dose reduction to 80% of the full dose before I could tolerate Taxotere.
Hope your onc finds a solution for you.
Alice
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Thanks for the input, Alice. I haven't heard of Piriton. Will look into that.
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I was on Taxotere and Carboplatin and Herciptin. I ended up with kidney failure and hospitalized. They pulled me off some of my regular meds, changed some and cut my dose 20%. The following treatment they cut it a bit more. Got thrugh it til Herceptin only got my heart and had to quit that. Hang in there. There is a lot they can fine tune.
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I also had a reaction to taxotere on my second treatment.(First treatment was uneventful). It was very scary...first a pain in my stomach, tightness in my chest, my body felt like it was on fire, and (I was told) I became bright red. Luckily the nurse was walking passed me when this happened so she immediate stopped the IV and began the steroids and Benadryl. So for round 3 and 4 I had abraxane which I did much better on. However, since abraxane is much more costly, it took insurance awhile to approve it.
MountainMia-best of luck and let us know what your MO advises.
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Moonflwr and Flower216, that's scary stuff. My MO did discuss Abraxane but said Taxol would be the next thing to try, in a ACT combo.
Thanks much for your comments. It's good to know there is a way through, one way or another.
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I had a reaction to Taxotere on Friday, two days after my second infusion. I was flushed and developed blotches on my arms and legs. The MO looked at the rash and said she has to research other options, but the first choices were 1 more steroids (runs the risk of triggering steroid-induced diabetes--not good) or 2 a new regimen (if changing to another drug, my first two cycles won't count and I'll be starting all over again).
Did anyone else run into this? I don't want diabetes, and I also don't want to have to start chemo all over again! I was scheduled for four cycles and thinking I was halfway through felt good.
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Mama...sorry you are going through this.. I was scheduled for four treatments of taxotere.. and during my second infusion, I had an allergic reaction. So my third and fourth treatments were with abraxane and I did not have to start all over. By the way, abraxane's side effects were easier to tolerate. good luck!
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flower216 thank you! I will see my MO on Tuesday and discuss it with her. I hope she has a plan.
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