I have a couple of appointments in my diary. On Monday, I go to see the oncologist to get the results of the various tests they did to make sure I am healthy enough to go on Pembrolizumab, and hopefully to sign consent forms. On Friday 26th May, I am due to start treatment.
Ahead of the appointment, I have been investigating the standard treatment protocol. I think I have said before that my own oncologist wasn’t clear last time I saw her. This is fairly new for TNBC and I think I will be my hospital’s first case. A couple of NHS trusts have protocols publicly visible on the internet, and I have to say it sounds daunting.
A treatment cycle is 12 weeks. You can either have Pembrolizumab on a lower dose at the start of weeks 1,4,7 and 10, or on a higher dose at the start of weeks 1 and 7. Meanwhile Paclitaxel or NAB-Paclitaxel is given once a week for 3 weeks, then a week off, throughout the cycle. So if you are on the lower dose Pembrolizumab, the only weeks you don’t have to go to the hospital are weeks 8 and 12; whereas the higher dose means you also get week 4 as a free week. Given you also have to go for a blood test the day before each infusion, it’s going to limit my life somewhat. It carries on for up to 2 years unless you have progression or too much toxicity. I think in practice, if it works for you, the Paclitaxel will be dropped at some point and you continue with Pembrolizumab only.
The life limitations are probably better than the life limitations of doing nothing.
