Antineoplastic Agents
The 54-year-old Hispanic female will need hormonal therapy as the standard initial treatment for her non-metastatic HER2-negative breast cancer diagnosis. However, chemotherapy treatments may as well be performed in this case. American Society of Clinical Oncology states that this type of breast cancer does not have a specified kind of chemotherapy recommended for it. Various types of drugs, including anthracyclines and taxanes, which are to be given sequentially rather than as a combination, are available. Additionally, platinum-based antineoplastic drugs along with capecitabine (Xeloda), vinorelbine (Navelbine), eribulin (Halaven), ixabepilone (Ixempra), and gemcitabine (Gemzar) medication may be given.
The anthracyclines glycoside antibiotics have acute and chronic adverse effects but with limited clinical activity. Chronic cardiotoxicity is a major adverse effect of these antibiotics which may be fatal due to the progression of permanent, amassed dose-dependent, dilated heart failure. Metabolism of taxanes takes place in the liver by the cytochrome P-450 enzymes and are excreted in the bile. The pharmacotherapeutics associated with paclitaxel therapy mainly include peripheral neuropathy, neutropenia and in rare cases, cardiotoxicity. Docetaxel toxicity mostly gives rise to a cumulative dose of fluid retention syndrome and sometimes bone marrow suppression. Moreover, the various dose-limiting toxicities associated with platinum-based anticancer drugs, tumor relapse, and development of drug resistance among other several challenges have severely deteriorated the quality of patient life.
Usually, chemotherapy should carry on until the disease gets worse if a patient is not suffering from adverse drug reactions. Sooner or later, chemotherapy may no longer be able to control the growth of cancer cells. In such a case, this patient may choose to end chemotherapy while continuing to receive palliative care. Healthcare providers should take into consideration several factors including the overall health of a patient, previous treatment received and potential side effects before deciding on the best therapy option.