Cytoxin versus Carboplatin

[Brenda S]

I have been given two different chemotherapies from oncologists. One suggested Cytoxin/taxotere/herceptin. The other suggested Carboplatin/taxotere/herceptin. Is this a big difference? Both had the same schedule. Six infusions on a three week cycle followed by herceptin alone for the remainder of the year--12 more infusions.

Should I get a third opinion?
Thanks friends!
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[kcherub]

Hi! I wasn't offered just CTH, A was also in that protocol. That was over a year ago, so maybe CTH is the new offering. I haven't seen any "stats" on CTH, just TCH (which is what I had).

I found TCH to be very doable, but then again, I didn't have anything else to compare it to. I have heard that Taxol is a bit harder on you, but once again--it can vary from person to person.

I hope that someone out there has some statistics on the comparison of CTH vs. TCH for you.

Take care,

[kcherub]

Oh, I also forgot to add...other than the mammosite (which I REALLY wanted) and ER/PR, we have a really similar diagnosis!

[chrisy]

Brenda,
Ah the fun of getting multiple opinions and having to make choices when you may not feel prepared to do so. My onc once told me that when you get 2 doctors in a room, you should be prepared to get at least 3 different opinions! I think that's true.

I would ask each of the oncologists WHY they recommend the C that they do, as you have 2 different opinions. What is their reasoning, what are the pluses and minuses of each. I'd do that before going for a tiebreaker 3rd opinion, because you might get even more different recommendations.

[Becky]

Dear Brenda

I can give you some facts to ponder.

The doctor that recommended the carboplatin therapy is going on sheer "standard of care". There have been Herceptin trials that use Adriamycin+Cytoxan (AC) (4 rounds) followed by Taxol (12 weekly rounds) . These women were compared to women who took 4 rounds of AC followed by 12 weekly rounds of Taxol+ Herceptin. Another group of women took 6 rounds of Taxotere (this is a taxane and is very much like Taxol)+Carboplatin+ herceptin. The Herceptin groups continued with Herceptin alone out to one year.

The women in either Herceptin group did much, much better than the women who did not get Herceptin. Also the Taxotere,Carbo,Herceptin women did not experience heart damage or leukemia (since the Adriamycin can contribute to this). So - the Carboplatin regime has a trial behind it.

For Cytoxin, there are trials but none that contain Herceptin (that are finished with data) however the trials that have data compare Taxotere/Cytoxin to Adriamycin/Cytoxan. This was done to see if TC is more tolerable (especially to the heart) for older women. (In this case - older means over 70 yrs. Many women in this age group might not get chemo even if they need it because it may not be wise). This study said that TC is not only tolerable for this age group (heart wise) but also worked better. Adding Herceptin is assumed to be safe and I know of one woman that I counseled recently via the Amer Cancer Society's "Reach to Recovery" that is taking that combo and tolerating it very well.

One question I would ask the doctor who recommended the cytoxan combo is what data he has on stats versus the Carbo combo and why was it recommended (there is a trial going on now at Dana Farber for Stage 1 women using only Taxotere+Herceptin but adding Cytoxan is different than that). That combo, however, should work just fine and for Her2 neg women TC is a great combo versus AC and the study used women of all pathologies (and was done prior to using Herceptin in early stage).

If you have any questions at all - ask. That is the only thing I can think of to be specific about.

[Brenda S]

Thanks to all who have replied. I'll continue to research this and let you all know what and why I decided to do. Anymore suggestions are most welcome.
THANKS!