How would you modify neoadjuvant chemotherapy for a stage 2-3 triple negative breast cancer who has baseline grade 2-3 neuropathy?
She otherwise does not have any BRCA mutations nor any underlying cardiac disease.
Answer from: Medical Oncologist at Academic Institution
There are a few options I would consider. First, I would administer 4 cycles of dose-dense AC - assuming she has normal cardiac function at baseline - which typically has no significant neurotoxicity. If the patient has a very good response, I might stop there and send her to surgery. If she ha...
Comments
Medical Oncologist at Christie NHS Foundation Trust I would not use docetaxel but might consider weekl...
Medical Oncologist at Warren Alpert Medical School of Brown University I disagree - I beleive that nab-paclitaxel is no l...
Answer from: Medical Oncologist at Academic Institution
The grade 2-3 chronic neuropathy poses a challenge for taxane chemotherapy. I would not use taxane in this setting. It would be helpful to know what is the etiology for the neuropathy and whether the comorbid condition also put her at a risk for anthracycline related cardiac toxicities. ...
Answer from: Medical Oncologist at Community Practice
Depends on the degree of the pre-existing neuropathy and if related to DM can be monitored or the dose altered in any case I would have a discussion with the patient and monitor closely if giving a taxane
Comments
Medical Oncologist at Siri Onclogy and hematology Infusion Service I agree with Dr sikov . If this patient was a path...
I would not use docetaxel but might consider weekl...
I disagree - I beleive that nab-paclitaxel is no l...