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New Taxol Study

ladybug6
Posts: 8
Joined: Feb 2004

Hi,

I just completed 5 rounds of Taxol & Carboplatin. I am in remission. My oncologist suggested I try a Taxol maintenance dose for three treatments because it showed prolonged remission in ovarian cancer. Since I have significant peripheral neuropathy from the Taxol, he also recommended the option of Carboplatin only for an additional 3 treatments. Is anyone familiar with the Taxol study or on a Taxol maintenance regimen? Has anyone heard of taking Carboplatin alone to prolong remission? I appreciate your advice. I have uterine cancer, but my oncologist explained that advanced uterine cancer behaves like ovarian cancer. Thank you for your input.

ladybug6

BonnieR's picture
BonnieR
Posts: 1549
Joined: Jan 2004

I was in a study group at Minnesota University Hospital. I received the taxol/carpo combination (there are several combinations given in the study group - random computer selection matched us to treatments) I developed terrible side effects right away and on the 6,7 & 8th treatments has to stop the carbo - some people stopped the taxol or got something similar to taxol. I got hives and my throat and lungs I guess would swell, I felt like I was having a heart attack. I do have neuropathy in my feet, legs and fingers from the taxol now.... But believe it was worth it. I got my last treament on July 17th and as of last month have started having an increase in my CA125 count. So can't tell you for sure if it helped or not, but was definitely worth a try. Sorry for the long response and keep us posted on your progress. God Bless

groundeffect
Posts: 651
Joined: Mar 2003

Here's a quote from "Gilda's Disease" by M. Steven Piver, explaining the role of taxol in chemotherapy: "Taxol-the most important of these (drugs derived from natural plant products) drugs - works like no other type of chemotherapy, in that it paralyzes cancer cells during cell division, but does not destroy them. Instead, other mechanisms kill the cancer cells while they are paralyzed. Etoposide (VP-16) is another example of a paralyzing cancer drug derived from natural products."

I would recommend reading the "Chemotherapy Sensitivity Testing" posting to this board. Perhaps the suggestions offered could help you find a better chemotherapy. I would certainly look into it if I need further treatment!

"Gilda's Disease" was printed in 1996, and it gives descriptions of many drugs used to fight ovarian cancer, and why they are selected. I hope they'll do an update of it before too long. Best of luck to you. I had both uterine and ovarian cancers, no radiation, only taxol/carbo therapy.

spankygirl
Posts: 1
Joined: Feb 2004

It's been almost 2 1/2 yrs since my last taxol treatment & for the last several months I've developed a very irritating & sometimes painful facial twitch. Sometimes it doesn't bother me but other days esp. when I'm under stress it really gets bad. Sometimes it twitches so bad my right eye will close. I had 4 treatments of C & A & 4 treatments of taxol, 35 radiation treatments. Does anyone know if this is a side affect of the chemo or something to do w/ the tamoxifen I'm taking?

carkelley
Posts: 6
Joined: Jan 2004

Hi - I'm in remission too and I am on a Taxol maintenance program for the next 12 months. I haven't taken the Carboplatin by itself. I have the neuropathy in my hands and feet but its seems to go away about three days after treatment. Good Luck to you and you are in my prayers.

gdpawel's picture
gdpawel
Posts: 549
Joined: May 2001

Chemosensitivity Testing

Fresh samples of the patient's tumor from surgery or a biopsy are grown in test tubes and tested with various drugs. Drugs that are most effective in killing the cultured cells are recommended for treatment. Chemosensitivity testing does have predictive value, especially in predicting what "won't" work. Patients who have been through several chemotherapy regimens and are running out of options might want to consider chemosensitivity testing. It might help you find the best option or save you from fruitless additional treatment.

This kind of testing can assist in individualizing cancer therapy by providing information about the likely response of an individual patient's tumor to proposed therapy. In instances of severe drug hypersensitivity, failed therapy, recurrent disease and metastatic disease, it can provide assistance in selecting optimal chemotherapy regimens. Today, chemosensitivity testing has progressed to the point where it is 85% - 90% effective.

All available chemosensitivity assays are able to report drug "resistance" information. Resistance implies that when a patient's cancer cells are exposed to a particular chemotherapy agent in the laboratory, the cancer cells will continue to live and grow. Some chemosensitivity assays are also able to report drug "sensitivity" information. Sensitivity implies that when a patient's cancer cells are treated with a particular chemotherapy agent in the laboratory, that agent will kill the cancer cells or inhibit their proliferation.

Listing of "Reputable" Labs USA:

These labs will provide you and your physician with in depth information and research on the testing they provide.

Analytical Biosystems, Inc., Providence, Rhode Island. Ken Blackman, PhD. Solid Tumors Only. 1-800-262-6520

Anticancer, Inc., San Diego, CA. Robert Hoffman, PhD. Solid Tumors Only. 1-619-654-2555

Oncotech, Inc., Irvine, CA. John Fruehauf, MD. Solid Tumors and Hematologics. 1-714-474-9262 / FAX 1-714-474-8147

Sylvester Cancer Institute, Miami, FL. Bernd-Uwe Sevin, MD. Solid Tumors Only. (especially GYN). 1-305-547-6875

Human Tumor Cloning Laboratory, San Antonio, TX. Daniel D. Von Hoff, MD. Solid Tumors Only. 1-210-677-3827

Rational Therapeutics Institute, Long Beach, CA. Robert A. Nagourney, MD Solid Tumors and Hematologics. 562-989-6455 http://www.rational-t.com/

Weisenthal Cancer Group, Huntington Beach, CA. Larry M. Weisenthal, MD, PhD. Solid Tumors and Hematologics. 1-714-894-0011 / FAX 1-714-893-3659 / e-mail: mail@weisenthal.org

One interesting note about Dr. Larry Weisenthal (Weisenthal Cancer Group). Someone very close to him had advanced ovarian cancer a few years ago. She underwent heroic debulking surgery (from pelvic floor to diaphragm) and tissue specimens were sent for chemosensitivity testing which showed resistance to single agent cisplatin and carboplatin and resistance to taxol. The three drug combination of vinorelbine, gemcitabin and high dose tamoxifen was very synergistic and tested sensitive. She was treated with 6 cycles of gemcitabine, carboplatin, vinorelbine and high dose tamoxifen with only minimal nausea and with no other toxicity. Her CA-125 normalized, her bowel symptomatology normalized and she gained back all of the 25 or so pounds which she had lost. She stated that she now feels better than she has in years and will undergo a second laparotomy sometime soon. This person "never" would have benefited with taxol/carboplatin.

gorget
Posts: 23
Joined: Feb 2004

Hi ladybug6,
The Taxol study you are referring to is called the Markman study - I believe it was printed in the journal Cancer last year. The study suggests 12 months of Taxol treatments after whatever protocol one's doctor puts one on. It's supposed to assist with stopping recurrence.
My local oncologist was pushing me to do this - I was hesitant (especially for a year) because the carbo/taxotere protocol I'm one is very wearing (and don't we all just want to see an end to the cycles of treatments!). My gyn/onc yesterday suggested that I think of doing it (not necessarily for 12 months) if my CA125 starts to plateau (it's currently at 38 prior to last week's treatment). So, while it's not something I necessarily want to do, I will do it if it means helping with my counts. I'll know more in two weeks when I get my bloodwork done. Either way, I know I'm in for more treatments, but I'm just not sure of how many.
I hope this helps. You should be able to get at least the abstract on the journal submission by Markman from the website. Just so you know, they stopped the study so do not have any idea whether or not it actually has any beneficial, long term positive effect on remission. Something to think about, and the reason I didn't want to do it - no real proof/data to indicate it is worth the extra time spent hooked up to an IV.
Good luck, and be well.

gdpawel's picture
gdpawel
Posts: 549
Joined: May 2001

Why should ovarian cancer patients receive Taxol when it hasn't been proven to improve survival compared with either single agent cisplatin, single agent carboplatin, single agent oral melphalan or even single agent oral Chlorambucil?

The largest ever international clinical trial of treatments for ovarian cancer, has concluded that standard initial chemotherapy drug treatments for women with ovarian cancer are equally as effective adding the drug paclitaxel (Taxol) to those treatments, and also cause fewer side effects. The surprise finding was published in the August 17, 2002 edition of The Lancet.

The study’s results suggest that, for initial treatment of women with ovarian cancer, widely used standard drugs are equally as effective as treatments that include paclitaxel and, on balance, standard treatments such as carboplatin may be considered the preferred treatment as they have fewer side effects.

A large, multi-institutional trial (Gynecologic Oncology Group # 132) randomized ovarian cancer patients to (1) Taxol/cisplatin, (2) Taxol alone, and (3) cisplatin alone. Patients could be crossed over to the other drugs in the event of disease progression. The result? Taxol alone was inferior to the other two regimens, while cisplatin alone was, if anything, superior to the Taxol/cisplatin combination in complete remission rate and duration of response and most certainly was no worse than the combination.

So what is the level of evidence supporting the use of Taxol/cisplatin over cisplatin alone? And given that carboplatin has been shown (in combination trials) to be therapeutically equivalent to cisplatin, but less toxic, is it not reasonable to consider using single agent carboplatin alone, as first line chemotherapy?

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