Taxol chemotherapy

[Krista40]

Hello, and thank you for taking the time to review my question.

I have completed 4 cycles of AC, 1 cycle every 3 weeks.  I have 4 cycles of Taxol coming up next, 1 cycle every 3 weeks.  I have these questions regarding Taxol:

Q1. Even though my AC cycles were 3 weeks apart, is it okay to have my cycles of Taxol only 2 weeks apart (dose dense?)

Q2. Are there benefits to dose-dense Taxol regiments (e.g. a cycle every 2 weeks) vs. "normal" regiments (e.g. a cycle every 3 weeks)?

Q3. Is dose-dense chemotherapy (especially in the case of Taxol) now a Standard level of care?

Q4. How is the Taxol dosage calculated for a dose-dense regiment of Taxol: 4 cycles, 1 cycle every *two* weeks?  (I am 5'11", weighing 133 lbs.) ?

Q5. How is the Taxol dosage calculated for a "normal" regiment of Taxol: 4 cycles, 1 cycle every *three* weeks?

Thanks!  -Krista

[PaulMD]

Hi there.

Regardless of the interval, dose dense or not, Taxol dose is computed at 175mg/m2 of body surface area.

The pivotal clinical trial of CALGB (cancer and leukemia group B) number 9741 demonstrated the superiority of dose dense regimens in terms of disease-free survival compared to that of the 3-week interval.  However, this study started the dose dense fashion even with AC (AC every two weeks), and I'm not sure if we can extrapolate the data if only the Taxol part is given as dose dense.

Dose dense regimens are standards of care for some, but not all centers.  There are different philosophies regarding this, and the decision would depend on the resources and circumstances at hand (since dose dense regimen would require additional hematopoietic support in the form of drugs like filgrastim or neulasta).

Regards and God bless.