Can Abraxane stop breast cancer spread for my mom at 55?

Question

Hi doctor,

My mother, who is 55 years old, is undergoing chemotherapy for breast cancer T4 M1 (less than 5 mm non-avid in lymph node above lung) Nx, after mastectomy. She is HER2 positive, and the other two receptors are also positive. We have two different opinions in front of us from the two best oncologists here. The first opinion from our current oncologist is FAC 3 cycles (already given), Daxotel (3 cycles and the second one is going on) and then to continue with Herceptin.

The second opinion from another senior oncologist is that since she is HER2-positive, the above regimen of the FAC and Daxotel is useless. She needs to start chemotherapy all over again with 6 cycles of Abraxane along with Herceptin. Otherwise, metastatic cells will soon spread to the brain.

The second opinion hit us and gave a big shock. She has just finished the task of chemotherapy, and we hear that the drugs used were useless. I am here to know the reality of the above and to seek advice on which route we should take.

Please help us.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Your mother seems to be in stage 4 and less likely to be in stage 3. However, to give the benefit of the doubt, I think that people have considered giving chemotherapy followed by a response evaluation. If the result is favorable, they may even opt for surgery (variable).

In stage 4 hormone-positive, we prefer to give the only antihormonal agent. In her case, anti-HER2 therapy has to be added as she is positive for it. I will not suggest the second type of chemotherapy at this time if there is no obvious progression.

In my opinion, you should continue with the third dose and see the response on radio imaging. We may plan to continue anti-HER2 with hormonal agents, while keeping her on close follow-up. In a less common scenario, if the response is phenomenal, then we may plan surgery. But this will need further discussion. Do not worry, she should do well.

For further information, consult a medical oncologist online.

Take care.