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Topic: Carboplatin-Taxol + Keytruda - Thread to Share Your Experience

Forum: Triple-Negative Breast Cancer —

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

Posted on: Sep 3, 2021 05:41PM - edited Sep 30, 2021 04:09AM by oddboood

oddboood wrote:

Hi Everyone,

Next week I will start a 24-week regimen of weekly Carboplatin/Taxol with Keytruda once every 3 weeks for 12 weeks. I understand this is the newest protocol for TNBC, so I thought it might be good to start a thread. I look forward to the chance for all of us to learn from one another!

Aleta

Dx at 56. Trying to make lemonade. Dx 8/3/2021, IDC, Right, 2cm, Stage IIA, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 9/6/2021 Carboplatin (Paraplatin), Taxol (paclitaxel) Immunotherapy 9/7/2021 Keytruda (pembrolizumab)
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Sep 3, 2021 07:47PM NorCalS wrote:

Well wishes to all those on this new regimen. It wasn’t available when I was treated, so I hope it really works well for all the newbies

Dx 6/17/2019, IDC, Left, 6cm+, Stage IIIC, Grade 3, ER-/PR-, HER2- Chemotherapy 6/24/2019 AC + T (Taxol) Chemotherapy 4/6/2020 Xeloda (capecitabine) Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Sep 16, 2021 03:54PM Everythingispossible wrote:

Not certain what the treatment plan will be. See MO on Monday, September 20th. Waiting for Oncotyping. I had a lumpectomy on September 1st. In reading the FDA approvals for the new protocols it appears that this is a neoadjuvent treatment. Hoping that isn't the case. I'll take any advantage I can get!



Dx 8/13/2021, IDC: Medullary, Left, 1cm, Stage IB, Grade 3, 0/1 nodes, ER-/PR-, HER2-
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Sep 16, 2021 04:01PM oddboood wrote:

I'm having neuadjuvant chemo, but there are ongoing clinical trials of Keytruda as a TNBC adjuvant treatment - might be worth sharing with your MO: https://www.cancer.gov/about-cancer/treatment/clin...


Dx at 56. Trying to make lemonade. Dx 8/3/2021, IDC, Right, 2cm, Stage IIA, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 9/6/2021 Carboplatin (Paraplatin), Taxol (paclitaxel) Immunotherapy 9/7/2021 Keytruda (pembrolizumab)
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Sep 16, 2021 06:43PM Moderators wrote:

Welcome, Everythingispossible! We're so sorry you find yourself here, but we hope you find this community to be a helpful and supportive place.

The Mods

To send a Private Message to the Mods: community.breastcancer.org/mem...
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Sep 16, 2021 09:53PM Kendara wrote:

Thanks for starting this thread. I was just diagnosed with BC on September 13 and found out it was triple negative on September 14. I still have to have an MRI and a PET scan. I’m going to be starting neoadjuvant chemotherapy on September 29 with carboplatin, taxol and Keytruda. So I will let you know how it goes for me. I’m really grateful that this new protocol was approved in time for me to try it. After 3 months of this combination, I have 3 months of AC and continued Keytruda. MO is throwing everything at this. Hugs and prayers for everyone else who is on the chemo train. Heart

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Sep 17, 2021 04:58AM oddboood wrote:

Hi Kendara,

Thanks for joining this thread! It looks like we are among the first to have this new treatment plan - 3 months weekly carbo/taxol with Keytruda and then 3 months weekly AC with Keytruda. I had my second infusion this week, and so far, side effects have been very mild. The worst thing has been constipation from the Zofran prescribed to treat nausea (that was pretty unpleasant, so be sure to take extra care with diet and have some over the counter remedies handy if they give you Zofran). I've also had mild fatigue - I don't usually take naps, but now they are part of my daily routine. No hair loss so far, but it's early days, I know. The infusions themselves have been easy - I actually slept through both of them due to the Benadryl they add in to stave off any allergic reactions. I'm told they will be reducing that going forward as long as I have no allergic reactions.

I'm told the effects will be cumulative, so I'm not counting on it being this easy for the duration and I'm doing my best to take advantage of these days when I still feel pretty "normal." Smile

Good luck with your upcoming scans. Hugs and prayers to you and all our BC sisters!

Aleta


Dx at 56. Trying to make lemonade. Dx 8/3/2021, IDC, Right, 2cm, Stage IIA, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 9/6/2021 Carboplatin (Paraplatin), Taxol (paclitaxel) Immunotherapy 9/7/2021 Keytruda (pembrolizumab)
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Sep 17, 2021 04:41PM NorCalS wrote:

Oddboood and Kendara,

Thanks for checking in and letting the rest of us know how you guys are doing. I was diagnosed in mid 2019, so I had AC-T only, no immunotherapy. The advice I received from oncology nurses, integrative oncologist, and TNBC survivors was to walk everyday if possible. They said it will help keep your WBC up. I walked early in the morning and it helped me psychologically as well. You don’t have to exercise hard, but getting some exercise everyday can be helpful

Dx 6/17/2019, IDC, Left, 6cm+, Stage IIIC, Grade 3, ER-/PR-, HER2- Chemotherapy 6/24/2019 AC + T (Taxol) Chemotherapy 4/6/2020 Xeloda (capecitabine) Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Sep 30, 2021 03:48AM - edited Sep 30, 2021 04:12AM by oddboood

Had my fourth infusion yesterday, and saw my PA as well. After just three weekly infusions of Carbo-Taxol (and one of Keytruda), my formerly 2cm hard-as-a-rock, easily palpable tumor can no longer be felt - by me or the PA in my MO's office. Yay!

The other god news is that side effects have still been minimal - nausea controlled easily by Compazine, plus a few minor mouth sores that don't really hurt and seem to be controlled with a non-alcoholic mouthwash. I had some fatigue in the first two weeks, but the last two weeks my energy has been great. I'm going off the steroids and the Benadryl since I've had no signs of allergic reaction to the Taxol. We'll see if that induces a dip in energy, but since I only take three dexamethezone once per week on chemo days, I don't anticipate a huge change. Per my chemo nurse, the weekly regimen can be much easier to tolerate - even though you don't get the rest time between infusions, the lower dosage seems to be easier for people to handle. Also, no hair loss yet, and blood work looks really good for all the key WBC markers!

Here's hoping others on this new regimen have a similar experience - at least in the first weeks. I know there's still five months and 20 infusions to go, and I'm prepared for a rough time as treatment progresses - especially after the switch to AC at the 3-month mark. Still, thought this might be a welcome update for others who may be beginning this regimen.

Love to all,

Aleta



Dx at 56. Trying to make lemonade. Dx 8/3/2021, IDC, Right, 2cm, Stage IIA, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 9/6/2021 Carboplatin (Paraplatin), Taxol (paclitaxel) Immunotherapy 9/7/2021 Keytruda (pembrolizumab)
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Sep 30, 2021 09:49AM NorCalS wrote:

Oddboood,

I am so glad that the new treatment is working. I hope the side effects stay manageable. AC is tough, but I felt like it was very effective. My 6+ cm tumor shrank the most during AC, so hopefully AC will help kill off any lingering cancer cells you may have

Dx 6/17/2019, IDC, Left, 6cm+, Stage IIIC, Grade 3, ER-/PR-, HER2- Chemotherapy 6/24/2019 AC + T (Taxol) Chemotherapy 4/6/2020 Xeloda (capecitabine) Radiation Therapy Whole-breast: Breast, Lymph nodes, Chest wall
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Sep 30, 2021 02:22PM mamacure wrote:

that’s amazing oddboood! Carbo (Taxol, carbo, keytruda) kicked my butt & had to drop 4th carbo. AC was the worst of all but every 3 weeks & only 4x. I got a dose reduction after the first AC. Now I’m on keytruda only and they said no nausea but I threw up in the parking lot afterwards. I think both carbo & AC worked well. Glad to know ofothers having this same treatment! Best of luck ladies. You can do it!

DX 3/23/21 | IDC LEFT | IBC LEFT | ER-/PR-/HER-2- (FISH) | T4b(inflammatory)N1, overall stage IIIc | Neoadjuvant Chemotherapy April 2021 Taxol, Carbo, Ketruda | Chemo May 2021 Abraxane, Carbo, Keytruda ,AC | Integrative Oncology & Accupuncture
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Oct 2, 2021 02:48PM AnnieG11 wrote:

oh, Aleta, I’m so encouraged by your post. I just started my first treatment last Tuesday and have been totally exhausted all week. Can hardly get out of bed. Dizzy. Weak. We are on the same regimen so I am looking forward to feeling better, hopefully. Please keep me posted.
I was feeling so unwell I started getting almost panic attacks which I have suffered from previously and take Paxil for. It always worked until I started the chemo and now I am trying to control my anxiety. The nurse bumped it up to 30mg from 20 but I’m afraid to take advice on these type of meds from a nurse. I’m just a mess. Not looking forward to next Tuesday.
thank you for allowing me to vent

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Oct 6, 2021 02:29AM Delta_Moon wrote:

My chemo starts Monday, every 3 weeks for 18 weeks. The Fabulous Dr Baker is very enthusiastic about this new combination of drugs and has very high hopes for a good outcome. My son is 2 years out from rectal cancer and is in total remission so I'm assuming the same will be true for me. My youngest daughter is getting married 2 weeks after my first treatment so I'm really hoping I can stave off the worst of the side effects for at least that long.

And it makes me laugh to see the typo in the thread title. My fingers are crossed that I don't wind up calling it KeyTURDa before this is all over with.

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Oct 9, 2021 04:26PM AnnieG11 wrote:

Had my second course last Tuesday. Felt great for the following few days. Today, Saturday, I can't even get out of bed I'm so weak. Has anyone experienced this? thank you

annie

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Oct 11, 2021 08:41PM Kendara wrote:

Aleta, I am so happy for your great response to your treatment! I had my third infusion today. Almost didn’t because my neutrophils were too low (after being too high last week!). Doctor decided to go ahead, but I have to get three filgrastim shots over the next three days to stimulate white blood cell production.

My side effects have included diarrhea, nausea, insomnia, flushing, neuropathy, loss of appetite, general malaise, loss of muscle mass, elevated blood glucose, low neutrophils, and a really foul taste in my mouth that was not relived by anything. That happened the day after the second infusion and lasted three days. Some of my side effects were related to the dexamethasone and some to the chemo drugs.

Despite the side effects, I am glad to be getting treatment. My tumor feels smaller and softer to me. I will have an ultrasound the day after the seventh treatment and that will be the real measure of whether the treatments are working. I feel like I’m getting the latest and best protocol and if I have a chance to beat this cancer, this is it.

My hair hasn’t fallen out yet, although I had it cut into a really short pixie in anticipation of the mess. My husband loves my super short hair, which he had never seen on me because I wore my hair long for 40 years. He’s already lobbying for me to keep it short after treatment ends and it grows back. We’ll cross that bridge when we come to it.

Sending loving thoughts and encouragement to all.

Kendar

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Oct 14, 2021 06:01AM oddboood wrote:

Thanks, Kendara! Sorry you are having a rough go right from the start. But yes, even with the crappy days, it does feel good to know we are kicking cancer's butt!

And welcome AnnieG, DeltaMoon, mammacure! It is so great to have this forum to share experiences. Especially since this treatment is so new for bc patients, I think we really can gather some important collective wisdom here. In that vein, here's an update from me:

So after a ridiculously easy first four weeks, it got real fast. Treatment five hit me hard - like all the pent up side effects suddenly decided to burst forth in a great big blaze of glory: hair falling out in big clumps, fatigue, painful mouth sores, and, as an extra bonus, the evening after the treatment I developed a rash that covered my face and body with itchy bumps, and a fever that spiked at 101.8 with a sore throat and a weird cough. Yowza.

I ended up in my hospital's acute care clinic the day after the fifth treatment - they weren't sure what was going on, but the fever went way down by late afternoon and tests showed no COVID or sign of other infection, so they let me go home. By the end of the following day I was fever free, and the rash had started to fade. The rest of that week was okay - just minor fatigue, nasty mouth sores, and ongoing hair loss (that hit me hardest - knew it was coming, but still - it just made me sad, you know?).

Enter treatment six - yesterday. A few hours after I got home, the rash came back along with a fever of 102.8 and a cough (this AFTER taking ibuprofen and naproxen). Called my MO and he said take Tylenol, some more Demexthesone, and Benadryl in addition to the ibuprofen, and go to the ER if I had trouble breathing. He seems to think the rash and fever are a Carboplatin reaction; it turns out that somewhere around treatments 6 - 8, many folks run into hypersensitivity reactions to this drug. My reaction is apparantly considered "mild;" they only get really excited if you show signs of full anaphylactic shock. Still, MO says he may cut out the Carboplatin completely. We have an appointment before my next infusion and will talk through it then. I'm feeling much better this morning - fever is gone, but the rash has me looking like a ripe tomato. Devil

Reading up on the Carbo toxicity issue, I learned that some doctors will do a skin test on you before treatment 6 -7 so they know ahead of time if you will have an hypersensitivity reaction. Then they can lower the dose or decrease the infusion rate to help mitigate the reaction. Might be worth mentioning to you MO as you enter week 5 -6.

Sending love and light to all, and sincere thanks for this wonderful supportive community.

XOXO,

Aleta

Dx at 56. Trying to make lemonade. Dx 8/3/2021, IDC, Right, 2cm, Stage IIA, Grade 3, ER-/PR-, HER2- (FISH) Chemotherapy 9/6/2021 Carboplatin (Paraplatin), Taxol (paclitaxel) Immunotherapy 9/7/2021 Keytruda (pembrolizumab)
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Oct 14, 2021 05:11PM mamacure wrote:

Hang in there oddboood, Carbo is hard, I ended up skipping my final Carbo, it was just too much.

DX 3/23/21 | IDC LEFT | IBC LEFT | ER-/PR-/HER-2- (FISH) | T4b(inflammatory)N1, overall stage IIIc | Neoadjuvant Chemotherapy April 2021 Taxol, Carbo, Ketruda | Chemo May 2021 Abraxane, Carbo, Keytruda ,AC | Integrative Oncology & Accupuncture
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Oct 18, 2021 03:38AM Delta_Moon wrote:

Week One Recap: Things did not progress in the order I expected them to. From what I've read and heard, I expected nausea first, then the muscle aches and exhaustion. Thinking I had caught a break with the nausea when there was no sign of it after 4 days. Monday and most of Tuesday were pretty normal days. Faded pretty quickly Tuesday evening and the muscle pain (not aches, actual pain) started. Spent most of my time in bed trying to get comfortable, with short spans when I had to get up and move around. Nothing much helped though so I wound up back in bed. None of the expected exhaustion to speak of, beyond just not being able to sleep. The nausea started Friday night (should have known I wouldn't escape it) and most of Saturday. No actual throwing up thankfully, just feeling like I needed to. Along with the nausea came the joint pain. First my shoulders and hips, then moving down to knees and ankles. Even rolling over in the bed was painful at that point. I had a burst of energy Saturday afternoon and got out to run a couple of errands in my "new" car. And because it's me, and I don't understand the concept of moderation, I wound up back in the bed by mid-afternoon. Woke up long enough to eat, then back to bed. Sunday morning the gas pains started. Hard abdominal gas pains. Dealt with that all day and into the evening. Nothing I tried gave me any relief so I'm open to suggestions.

Because this is my first round, I don't know if subsequent rounds will follow the same pattern but at least I have an idea of what to expect. The not knowing part was the worst. Just waking up and wondering "what next?" was making me crazy. At least now I feel a little more prepared. I will be 1/3 of the way through treatment by my birthday, halfway through by Thanksgiving and 2/3 by the New Year. I can do anything for that long if I break it down into manageable segments.

Of course, all of this may be moot by the next chemo round. My daughter is getting married Saturday and even though I don't feel stressed about it, I'm sure I am to some degree. How that is affecting me, I have no idea. Guess I'll find out in a couple of weeks.

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