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

Topics: Breast Cancer • Medical Oncology

She otherwise does not have any BRCA mutations nor any underlying cardiac disease.

Answer from: Medical Oncologist at Academic Institution

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 ha...

Comments

Medical Oncologist at Christie NHS Foundation Trust
I would not use docetaxel but might consider weekl...

Medical Oncologist at Warren Alpert Medical School of Brown University
I disagree - I beleive that nab-paclitaxel is no l...

Answer from: Medical Oncologist at Academic Institution

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. ...

Answer from: Medical Oncologist at Community Practice

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

Comments

Medical Oncologist at Siri Onclogy and hematology Infusion Service
I agree with Dr sikov . If this patient was a path...

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