How might you alter treatment for a breast cancer patient receiving standard taxane-based adjuvant therapy who develops an adverse reaction to the taxane (e.g. severe pneumonitis) after completion of ddAC?

Topics: Breast Cancer • Medical Oncology • NCI-CCC Tumor Board Question • Yale • NCI-CCC Breast Tumor Board Question

For a patient with high risk disease and a severe enough reaction that additional taxane-based therapy is contraindicated, do you consider alternate chemotherapy, and if so, what?

Answer from: Medical Oncologist at Academic Institution

The two questions to address in making a decision are how sure we are that the paclitaxel is responsible for the pneumonitis and how much we expect the taxane to contribute to reducing the patient's risk of recurrence.In regards the former, we know that many hypersensitivity reactions to standard (s...

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Medical Oncologist at Florida Cancer Specialists and Research Institute
Dr. @Sikov, thank you for this answer. When using ...

Answer from: Medical Oncologist at Academic Institution

Taxanes may cause an immediate hypersensitivity reaction, which can be due to either the taxane or to Cremophore. Interstitial pneumonitis is usually a delayed hypersensitivity reaction and is immune mediated. If the pulmonary toxicity precludes further use of taxanes, one could consider capecitabin...

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