Choosing Treatment Regimens in Patients with Triple-Negative Breast Cancer

Hyman B. Muss, MD, professor of medicine, UNC Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill School of Medicine, discusses how he chooses which treatment to use for patients diagnosed with triple-negative breast cancer (TNBC).

By using the PREDICT model, Muss is able to pinpoint what treatment regimens might be better for each individual patient. His preference is to use the anthracycline-taxane regimen if the trials show at least a few percent higher benefit and the patient has good cardiac function.

Data shows the regimen is very well tolerated in elderly patients, with 80% - 90% of patients over 65 getting through at least 4 cycles of this therapy.

A common side effect at the 12-week mark of the weekly taxane treatment is chemotherapy-induced peripheral neuropathy. Muss recommends coal gloves and booties for the hands and feet to help with this side effect, a cheap alternative that has proven to work with many patients.

Muss also uses a taxotere-cyclophosphamide (TC) regimen or cyclophosphamide methotrexate fluorouracil (CMF) regimen. There are a lot of options, Muss says, so perhaps avoiding the anthracycline-taxane regimen is appropriate.