Oral paclitaxel

LisaPizza

Interesting phase 3 trial for metastatic breast cancer using a modified oral paclitaxel compared to standard IV paclitaxel every 3 weeks, which found both better response and less neuropathy.  I wonder if it will eventually make it's way into our world for adjuvant or metastatic treatment!

 

https://www.ajmc.com/conferences/sabcs-2019/oral-paclitaxel-reveals-superior-confirmed-response-survival-in-patients-with-metastatic-breast-cancer-compared-to-iv-paclitaxel

 

Tradeoffs were higher neutropenia, infection, and GI size effects (described as "low grade and manageable," terms I never really trust), and also fasting apparently.  "The treatment involves having to fast for 4 hours before taking the encequidar, waiting 1 hour to take the oral paclitaxel, and then waiting 4 hours before eating, with 11 capsules taken in that time frame." They said however that patients were quite compliant due to being excited about avoiding IV therapy.

 

 

Fridays Child

Thanks, Lisa!

Very interesting.  9 hours is a long time to fast in the day time but I guess if you're taking 11 capsules you're not going to be doing much sleeping, either.

MAbound

Interesting option.

Well, my appetite went missing during treatment anyway except when taking the steroid, so it might not be that hard to do if you are taking it orally, especially since they are saying there are GI side effects with it. An interesting option if it gets approved for uterine cancer. I'd rather deal with fasting than neuropathy any day.

LisaPizza

I forgot to mention it was 3

I forgot to mention it was 3 times a week, not daily.

LisaPizza

MAbound said:

Interesting option.

Well, my appetite went missing during treatment anyway except when taking the steroid, so it might not be that hard to do if you are taking it orally, especially since they are saying there are GI side effects with it. An interesting option if it gets approved for uterine cancer. I'd rather deal with fasting than neuropathy any day.

That's what I thought too!

That's what I thought too!

Currently standard is IV carboplatin too for us, so I  guess IV would still be needed unless there are also other developments. Would still significantly reduce time at the infusion center though since taxol is what takes the most time. And the decrease in neuropathy is a huge benefit IMO even if you still have to go in for IV carbo. Also, in the setting of metastatic cancer, monochemotherapy is more likely to be an option.

Northwoodsgirl

Oral chemo

Interesting trial. Something I think about is variance in absorption based on our gut microbiome.  I also wonder about pelvic radiation and oral chemo. I personally couldn’t take 11 pills of anything without great difficulty. My luck they would exit my body whole! 

LisaPizza

Northwoodsgirl said:

Oral chemo

Interesting trial. Something I think about is variance in absorption based on our gut microbiome.  I also wonder about pelvic radiation and oral chemo. I personally couldn’t take 11 pills of anything without great difficulty. My luck they would exit my body whole! 

Between pelvic radiation and

Between pelvic radiation and microscopic colitis, I often wonder the same! But somehow the damn calories always seem get absorbed