Dose Dense AC followed by Taxol/Taxotere

[EllenFitz]

I am 46 and was diagnosed with Stage 2B breast cancer (2.1cm, 1 positive node, er/pr positive, her 2 negative) and had a lumpectomy two weeks ago.  I am selecting an oncologist and have been reading about dose dense chemotherapy.  Have any advantages been seen in doing the AC and Taxol in combination rather than sequentially? Is it any more toxic?  I'd like to really hit this thing hard and do all that I can to make it work.   Also, any advantages to Neulasta vs Neupogen?   Thanks so much!

[ly3]

I had dose dense chemotherapy and gave myself 8 neupogen shots in between treatments.  It shortened the wait time between treatments, helping me to get past it sooner.  I got used to the shots, and my white counts were never too low that I couldn't have treatment.  The Taxol recovery was nothing like the AC.  AC was 2 really awful fluelike days following the day after treatment.  Then I'd get up and rejoin the human race.  Taxol was a little fatigue, body aches and tingling in my feet sometimes.  I was told Taxotere could only be administered 3 weeks apart.  Instead of ordering the 8 shots of neupogen after the last treatment I gave myself one neulasta shot, because they last longer.  A month later I had a mastectomy and tram reconstruction.  If you want further info on my situation, let me know, as there were some other issues with the chemo.

[CCF-RN,MSN-rf]

Dear EllenFitz:  The rationale for doing AC+T sequentially is toxicity, especially in the dose-dense setting.  Early trials have suggested that there may be advantange to doing dose-dense therapy over the every three week schedule.  There is no advantage to neulasta over neupogen. However, due to the duration of neulasta, neupogen may be preferred in the dose-dense setting.  The only other potential difference is cost.  Neupogen may be a little less expensive.