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Wife given AC/T + HP for --+ (her2 3+)

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hope_addict
hope_addict Member Posts: 5

Hi, after doing significant research, I've realized that TCHP is the international standard chemotherapy for neoadjuvant Her2 positive breast cancer. However, my wife's oncologist says he prefers AC. She just had her 1st infusion of AC. I also discovered that the AC is down dosed by 25%. Normally in the AC leg the standard dose is 60mg/m2 of doxorubicin (adriamycin) and 600 mg/m2 of cylophosphamide, however my wife's first infusion was 45mg/m2 of doxorubicin and 600mg/m2 of cyclophosphamide. I haven't read anywhere about this down dose. Her symptoms were extremely mild after 1 week, just some fatigue, taste change, and some brain fog. We are happy for the lessened symptoms but now I am worried about the efficacy of a lower dose. Our followup is in 2 weeks. We will definately bring these issues up by I was wondering if anyone else is receiving AC/T + HP regimen for her2 positve neoadjuvant and if anyone else is familiar at all with downdosing the doxorubicin (adriamycin)?

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  • ratherbesailing
    ratherbesailing Member Posts: 125
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    Hope addict, does your wife perhaps have any underlying cardiac or liver conditions? Doxorubicin doses are sometimes lowered for those with other underlying conditions. Having said that, this is really something you need to discuss with your wife's doctor, who knows her specific situation and the chemotherapy drugs involved much better than anyone here will.

    If you are concerned, maybe send a portal message to her doctor now, rather than waiting until the date of her next infusion. It will give you more time to digest the information received. It's such a stressful time, I hope you get some answers that help.

  • hope_addict
    hope_addict Member Posts: 5
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    ratherbesailing, she definately doesn't have a heart condition that we know of, and she passed the muga test. They did do several blood tests so its possible they found something related to the liver that would warrant a lower dose. Thanks for the advice…I did, ofcourse consider calling them and asking (we don't have portals here in Canada, atleast not with messaging ability). We can only call the triage nurse. The thing is my wife is doing great..she is so positive, having faith in her doctors and I don't want to worry her. Right now these are my worries only, and I want to maintain the positive vibe. I think we'll probably have to wait for the meeting and I will just bring it up nonchalantly. She is so happy and after 6 days she is already more active than me.

  • laughinggull
    laughinggull Member Posts: 516
    edited May 31
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    Hi,

    I was triple positive (ER+ PR+ HER2+) with very agressive disease (grade 3) that had invaded my lymph nodes, and my neoadjuvant treatment was four sessions of AC and then another four of Taxotere + Herceptin + Perjeta. I also asked why not TCHP, even got a second opinion about the treatment, and they told me it was fine, and that both approaches were equivalent. I did fine with the first AC, but the effects are cumulative and the side effects were a little harder each subsequent time.

    I think its good due diligence to double check the treatment plan via second opinion appointment at another place.

    Can't tell about the dosage. I dont have notes that detailed.

    LaughingGull

  • hope_addict
    hope_addict Member Posts: 5
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    laughinggull. Appreciate the info, TY :) It seems both regimens are good choices.

  • hope_addict
    hope_addict Member Posts: 5
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    Just an update. The lower dose was confirmed by my wife's oncologist as precautionary due to borderline liver function tests which cleared up in following blood test. We are back to 60 mg/m2. fingers crossed.

  • ratherbesailing
    ratherbesailing Member Posts: 125
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    Thanks for the update, and happy to hear your wife's doctor was able to explain the dosage. Wishing you both all the best.

  • hope_addict
    hope_addict Member Posts: 5
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    ratherbesailing, thank you so much. And you nailed it with the liver. Thankfully it was transitory, and now I don’t have to worry about efficacy with a lower dose. Things are calming down a bit and she is still positive, and so am I.