How do you approach treatment for a patient with T2N0, ER+/PR+, HER2 negative breast cancer with planned TC treatment following a hypersensitivity reaction?

We don't have a trial with albumin bound paclitaxel plus cyclophosphamide vs. TC to guide you here. There is also some conflicting guidance on managing Docetaxel hypersensitivity. On one hand, some references say to rechallenge with Docetaxel is contraindicated (Lenz, PMID 17522249), but if you look at the Ovarian Cancer NCCN guidelines (page 54), there are instructions on what do do with taxane hypersensitivity. The cliff notes are that physicians should counsel patients about the risks of re-trying and can consider reusing the drug under the guidance of an allergist if the reaction was severe.

Most of the physicians in the US treating patients like this will likely not have an allergist on hand and not be able to efficiently admit the pati...