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How would you modify neoadjuvant chemotherapy for a stage 2-3 triple negative breast cancer who has baseline grade 2-3 neuropathy?

She otherwise does not have any BRCA mutations nor any underlying cardiac disease.
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Would you attempt taxane chemotherapy in a woman with baseline grade 2-3 neuropathy?

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3 Answers
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Medical Oncology · Warren Alpert Medical School of Brown University
Answered on

There are a few options I would consider. First, I would administer 4 cycles of dose-dense AC - assuming she has normal cardiac function at baseline - which typically has no significant neurotoxicity. If the patient has a very good response, I might stop there and send her to surgery. If she has had...

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Medical Oncology · Washington University School of Medicine
Answered on

The grade 2-3 chronic neuropathy poses a challenge for taxane chemotherapy. I would not use taxane in this setting. It would be helpful to know what is the etiology for the neuropathy and whether the comorbid condition also put her at a risk for anthracycline related cardiac toxicities. Oral CMF reg...

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Medical Oncology · Onc Assocs of South Florida
Answered on

Depends on the degree of the pre-existing neuropathy and if related to DM can be monitored or the dose altered in any case I would have a discussion with the patient and monitor closely if giving a taxane

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