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?

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...

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...