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Topic: TNBC Chemo cycles- need your help

Forum: Triple-Negative Breast Cancer —

Share with others who have ER-/PR-/HER2- breast cancer.

Posted on: Jul 30, 2021 03:08PM

Ntlw12 wrote:

Hi there, I’m still wrapping my head around all of this. According to the paperwork I received from the oncologist, I will receive a total of 17 cycles of treatment.

C1-4, the paper says

Paraplatin (Carbopatin) given with Keytruda &

Taxol given weekly, three weeks on, 1 week off

So my first question is, does this mean a cycle is four weeks?


Next Cycles 5-8

Adriamycin (Doxorubicin) given with Keytruda

Cytocan


Cycles 9-17

Keytruda (immunotherapy)


Anyone else have a similar treatment plan and can help me understand this better? I start August 6 and know they can explain it more, but thought I’d ask here as well.

Dx 7/12/2021, IDC, Left, 4cm, Grade 3, ER-/PR-, HER2-
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Jul 30, 2021 08:18PM mightlybird01 wrote:

Hi Ntlw12,

We don't know much about your diagnosis apart from the fact it is triple negative. Do you have any more information, such as tumor size, potential lymph node involvement, genetic testing, what type (IDC or ILC)?


But this does sound like an unusual regime for the standard TNBC, but times are changing and it looks indeed very interesting and powerful. And as long as you trust this Dr. and your hospital, it sounds as this could be a good combo of all drugs known to work well with TNBC. But for a first line of treatment for early stage TNBC it is unusual. I am curious to see what other people think. Are you treated in a major cancer center?


Good luck and keep the faith!


Dx 4/12/2019, IDC/IDC: Medullary, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER-/PR-, HER2- (FISH) Chemotherapy 5/22/2019 AC + T (Taxol) Surgery 11/8/2019 Mastectomy: Right
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Jul 30, 2021 08:48PM - edited Jul 30, 2021 09:43PM by Serendipity09

I know this does not answer your question, but this was posted by moth on July 27, 2021 on the Calling All TNs discussion regarding Keytruda, maybe it will help you understand your plan of treatment better

Fresh from the FDA

FDA approves pembrolizumab for pts with high-risk early stage TNBC based on DFS improvement seen in KN-522

https://www.merck.com/news/fda-approves-keytruda-p...


My treatment plan was:

Adriamycin and Cytoxan for 4 cycles; so every 2 weeks I received AC for a total of four treatments.

Taxol for 12 weeks, but every three weeks I was given Carbopatin in addition to the Taxol.

Hope this makes a little sense. I'm sure others will chime in.

Best of luck to you and, yes, keep the faith!

Dx 3/2020, IDC, Right, 4cm, Stage IIB, Grade 3, 1/4 nodes, ER-/PR-, HER2- (IHC) Chemotherapy 4/1/2020 AC + T (Taxol) Surgery 9/17/2020 Lymph node removal; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 11/3/2020 Xeloda (capecitabine) Dx 7/2021, Right, 2cm, Grade 3, ER-/PR-, HER2- Surgery 7/9/2021 Reconstruction (left); Reconstruction (right) Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall Chemotherapy Carboplatin (Paraplatin)
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Jul 30, 2021 08:50PM Ntlw12 wrote:

I have a 4.5 cm mass. IDC, nothing else showed up in Breast MRI. I have CT and bone scan on Monday. I did have genetic testing, but results aren’t in yet. I’m 38 and my mother had colorectal cancer (diagnosed at 45, stage IV and at 58 she is still here with no cancer!) and my grandmother had ovarian cancer.


maybe I’m reading all these papers wrong. I am going to a great place that is a branch of Roswell Park out of Buffalo so I have faith in their plan.

Dx 7/12/2021, IDC, Left, 4cm, Grade 3, ER-/PR-, HER2-
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Jul 30, 2021 10:28PM mightlybird01 wrote:

I think, given your young age and relatively large tumor, they just want to be extra comprehensive and attack that cancer from all sides, including immuno-therapy right from the start. You may be one of the first patients to do this exact regiment, with the recent approval of Keytruda. Please keep us updated on how it goes. I am sure you are in great hands and once the treatment starts it all gets much easier as you enter your new routine and get used to the chemo plan.



Dx 4/12/2019, IDC/IDC: Medullary, Right, 2cm, Stage IIA, Grade 3, 0/3 nodes, ER-/PR-, HER2- (FISH) Chemotherapy 5/22/2019 AC + T (Taxol) Surgery 11/8/2019 Mastectomy: Right
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Jul 31, 2021 12:35AM moth wrote:

Ntlw12, I think they're proposing state of the art, most recent evidence based protocol.

Here is the July 27 Merck release about Keytruda getting the FDA approval. You'll see the first para essentially describes your treament regimen.

https://www.merck.com/news/fda-approves-keytruda-p...

I'll be SO interested to hear how you do! for ages early TNs usually got AC+T so that's what you'll see here in siglines. You're a groundbreaker but you're following in the footsteps of really good clinical trial results so it's really excellent that you can access this treatment right out of the gate!

best wishes & do let us all know how it's going.

ps. I think TN will need a thread for pembro for early stage (we have a thread for in the mets section already but this is a whole different thing)


I take weekends off

Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the Odds

Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/19/2020 Tecentriq (atezolizumab) Chemotherapy 11/26/2020 Abraxane (albumin-bound or nab-paclitaxel) Dx 12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, ER+/PR-, HER2- (IHC) Radiation Therapy 12/9/2020 External Hormonal Therapy 12/16/2020 Femara (letrozole) Dx 1/28/2021, IDC, Left, Stage IV, metastasized to bone Radiation Therapy 3/3/2021 External: Bone
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Jul 31, 2021 03:28AM Ebaker4395 wrote:

I receive Adriamycin and Cytoxan every 2 weeks.. which will equal to 6 treatments. My oncologist just suggested to me today to add Keytruda to my treatment.

I have to admit I'm a little hesitant about it. Scared of side effects mostly.

I've considered myself pretty lucky with the chemo treatments so far. Mostly just tired a few days after, nausea has been very light and easy to control and I had a few headaches.

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Jul 31, 2021 06:42AM NorCalS wrote:

Ntlw12,

It looks like you are getting the newest “standard of care” treatment for TNBC. It’s pretty exciting and I hope the best for you. Keep us posted on how you’re doing. Like Moth said, old protocol was AC (adriamycin, cytoxan) for four cycles - once every two weeks, then taxol for every week for 12 weeks. I think Santabarbarian had a slightly different protocol for her TNBC (carboplatin instead of adriamycin?).

Hopefully, those who were in the clinical trials for keytruda can chime in. You can also check this site for the keytruda thread.


Dx 6/17/2019, IDC, Left, 6cm+, Stage IIIC, Grade 3, ER-/PR-, HER2- Chemotherapy 6/23/2019 AC + T (Taxol) Chemotherapy 4/5/2020 Xeloda (capecitabine) Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall

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