Xeloda as adjuvant chemo for TNBC - dilemma!

Good evening :slightly_smiling_face:

My onco Dr has offered me Xeloda/capecetabine tablets as adjuvant chemo - this is entirely my decision, as she thinks the benefits will be minimal given the neo-adjuvant chemo I had. She admitted that she’s only offering me xeloda as one of her other patients insisted on taking it. There doesn’t seem a consensus between experts as to benefits, and there seems to be differences in prescribing guidelines between different regional cancer centres around the country - in Yorkshire
(where I am) it’s not generally offered but appears to be prescribed in London.
I’m loathed to have 6 months of further chemo, and side effects to boot, if there’s little or no benefit. Any advice or a different perspective would be greatly appreciated!  Thank you.

I was diagnosed August ’ 22 with TNBC, in my late 40s:
• neo-adjuvant chemo: 3 cycles of epirubicin + cyclophosphamide every 21 days; 12 weeks of paclitaxel + 4 cycles of carboplatin every 21 days; tumour shrunk from 22mm to 15mm
• September: tested for genetic markers, results were normal
• February: WLE + 3 sentinel nodes removed; biopsy - clean margins + no sign of cancer in lymph nodes
• just completed 13 fractions of radiotherapy
• will start biophosphanate treatment (Zolendroic acid IV) in June - once every 6 months for 3 years

That is a dilemma. But I was researching taking another medication like you after my chemo and probably could have but decided not to for some reasons that may help you. Simply put there was no studies out there that showed it would personally benefit me due to my pathology results, I had already gone through substantial treatment, and the side effects of that medication could be intense. She simply didn’t think the rewards outweighed the risks and I trusted her advice. I think I would make your oncologist actually recommend to you what she would do if she was you. That’s her job anyway. 

Studies have shown that some people with primary breast cancer may benefit from capecitabine. This includes people with breast cancer that is triple negative. People who have chemotherapy before surgery may be offered capecitabine after their surgery. Your treatment team will discuss with you if this is an option. 

Hi guiness2001  

Thanks for posting. It’s understandable you’re loathed to have further chemotherapy if there’s little or no benefit and are looking for further information.  

As Alexon57 has suggested, some studies have shown that some people with primary breast cancer who have chemotherapy before surgery may benefit from capecitabine following surgery. This includes people with triple negative breast cancer.  

As Kay0987 has suggested further treatment recommendations depend on each individual’s pathology report and their response to neo - adjuvant chemotherapy.   

I wonder if it would be possible for you to have a further conversation with your oncologist and breast care nurse about the benefits for you based on your pathology report, so that you are able to make a more informed decision.  

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