What alternate neo-adjuvant backbone chemotherapy would you recommend in a patient with ER+ HER2+ clinical stage II breast CA with severe pan-colitis following a cycle of TCHP with docetaxel?
Answer from: Medical Oncologist at Academic Institution
I would switch to weekly paclitaxel and carboplatin with trastuzumab only, but might retry pertuzumab if the patient gets through 6 weeks without recurrent diarrhea. This is actually my preferred version of TCHP (including the pertuzumab), which I find to be better tolerated than the every-3-week do...
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Answer from: Medical Oncologist at Community Practice
I've seen docetaxel induced severe colitis (and this has been described). The typical characteristics of taxane induced colitis was described by Chen et al., PMID 31892799, and may be helpful to sort this out. However, the likely culprit I think is still pertuzumab. The CR rate of TCHP is lessened w...
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Medical Oncologist at NYU Langone Medical Center
Thanks for the helpful comments.
Thanks for the helpful comments.
Answer from: Medical Oncologist at Community Practice
NCCN-based options include Doxorubicin/Cyclophosphamide followed by paclitaxel with trastuzumab for 1 year commencing with the first dose of paclitaxel as a preferred HER2-targeting adjuvant regimen. The Docetaxel/Carboplatin/Trastuzumab regimen is also a preferredregimen, especially for those with ...