Info
prechemo_TNBC
< Diagnostic >
- for recurrence early stage TNBC, consider CT scan for chest, abdomen, and pelvis
- consider PET-CT
< Theraputic >
- arranged Por-A implentation
- Cyle 1-4 (Cycled every 3 weeks)
- Doxorubicin 60 mg/m2, Cyclophosphamide 600 mg/m2
- Pembrolizumab 200 mg (out-of-pocket expense $65,226NTD x 2 vial x 4 = 521,808)
- Cycle 5-8 (Cycled every 3 weeks)
- Docetaxel* 60 mg/m2
- Pembrolizumab 200 mg (out-of-pocket expense $65,226NTD x 2 vial x 4 = 521,808)
- then proceed to surgery
- post-op XRT if indicated
< Education >
- explained reason of < adjuvant / neoadjuvant > chemotherapy: achieve pathological complete response (pCR), to cure and lower the risk of recurrence/metastasis.
- explained chemotherapy schedule
- explained potential chemotherapy toxicities:
- <> cyclophosphamide: bone marrow function compromised, hemorrhagic cystitis
- <> doxorubicin: cardiotoxicity, with life-time culmucation 450-500 mg/BSA (300mg/BSA this course)
- <> docetaxel: stomatitis, persistent febrile neutropenia, cutaneous reactions, moderate neurosensory effects
- explained potential ICI toxicities:
- pembrolizumab: skin rash pneumonitis, colitis, hepatitis, hypophysitis, thyroid dysfunction, diabetes mellitus
- suggested high protein diet, not suggested chicken essence because it may confound the lab.