Oncura

Paclitaxel + Trastuzumab (TH): what to expect, day by day

Breast - HER2+21-day cycle5 effects documented

A gentler HER2 regimen: weekly paclitaxel plus trastuzumab. The main things to watch are nerve tingling and (rarely, reversibly) heart-pumping changes.

Weekly paclitaxel ×12 + trastuzumab (then trastuzumab to 1 year). Designed as a LOW-toxicity regimen for small HER2+ tumors (APT trial). Grade 3-4 rates are trial-verified; several any-grade rates were not separately quantified.

Timed to the cycle

Day 1 is the day of your infusion. These are the effects a retrievable document ties to a day range for this regimen — not a prediction about you.

Infusion reaction

During or just after an infusion

An allergic-type reaction during an infusion. Premedication is given for paclitaxel; trastuzumab reactions are mostly with the first dose.

Call your team urgently: Rash, trouble breathing, or swelling during/after an infusion — tell the team immediately.

severe in 1.7% · Timing is part of what this effect is · from Paclitaxel, Trastuzumab

Neutropenia

Typically around days 8–15

Generally mild with weekly low-dose paclitaxel.

Call your team urgently: A temperature of 100.4°F (38.0°C) or higher — an emergency.

severe in 4.2% · Timing from the manufacturer’s prescribing information · from Paclitaxel

Hair lossPROVISIONAL

Typically around days 14–21

Common, though weekly paclitaxel often causes less complete loss; grows back after treatment.

Timing from a drug-monograph reference · from Paclitaxel

Not tied to a cycle day

These build with the number of doses, or are measured from when treatment started, so a cycle day would be the wrong shape for them. Each keeps the timing its own source states.

NeuropathyPROVISIONAL

Builds up with the number of doses rather than arriving on a particular day of the cycle. Tell your team early — adjusting the dose is what helps most.

Tingling or numbness in the hands and feet, building over the 12 weekly doses. Mostly mild; often improves after finishing.

Call your team: New or worsening numbness, or trouble with buttons/zippers.

reported by about 40-60 (mostly mild, estimate)% of people; severe in 3.2% · Timing from the manufacturer’s prescribing information · from Paclitaxel

Cardiotoxicity

checked by echo/MUGA every ~3 months

Trastuzumab can temporarily weaken the heart's pumping, usually silent and picked up on scans, and it typically recovers when the drug is paused.

Call your team: New shortness of breath, leg/ankle swelling, or a racing/irregular heartbeat.

reported by about 3.2% (asymptomatic LVEF decline) of people; severe in 0.5% · from Trastuzumab

Where this comes from

1. S1. Tolaney SM, APT trial (paclitaxel+trastuzumab) (2015) — PMID 25564897
2. S2. Trastuzumab / paclitaxel FDA prescribing information — FDA label

Timing windows on this page rest on:

• Taxol (paclitaxel) FDA prescribing information — “Neutrophil nadirs occurred at a median of 11 days” source
• Definitional — an infusion reaction is one that occurs during or shortly after the infusion — “The timing is part of what the term denotes; there is no empirical claim here to source.”
• BC Cancer Drug Manual — paclitaxel — “usually complete, generally occurs 14-21 days after administration of paclitaxel; onset sudden, often occurring in a single day” source

A window appears here only where a retrievable document ties it to a drug in this regimen. Where nothing could be found, the window was removed rather than estimated — so a missing time is an honest gap, not an oversight.

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