This information is in addition to your consent form(s) and booklet, 'SACT - a guide for patients and their carers'.

Your treatment

Paclitaxel, carboplatin, epirubicin and cyclophosphamide are anticancer drugs known as chemotherapy. Pembrolizumab is an anti-cancer drug also known as a targeted or biological therapy. This is a type of immunotherapy also known as a checkpoint inhibitor. This drug helps your immune system to find and attack cancer cells.

Before surgery

Pembrolizumab is given subcutaneously (under the skin) as an injection. Occasionally, this drug may be given intravenously (into the vein) through a cannula (fine tube) as an infusion (drip) over 30 minutes. The treatment is repeated every 21 days (3 weekly) for 8 cycles (24 weeks) and is given concurrently with PC-EC chemotherapy.

Paclitaxel and carboplatin (PC) are given into the vein (intravenously) through a fine tube (cannula) as an infusion (drip) over 1 hour (paclitaxel) and 30 mins (carboplatin) on days 1, 8 and 15 of a 21 day cycle for 4 cycles (12 weeks). Then followed by epirubicin and cyclophosphamide (EC) which are given into the vein (intravenously) through a fine tube (cannula) as bolus injections, via a fast-flowing infusion (drip) over approximately 30 minutes every 21 days for 4 cycles (12 weeks).

After surgery

Pembrolizumab is continued as a single agent after surgery. It will not restart until at least 2 weeks after radiotherapy (if needed) and will be administered as a subcutaneous (under the skin) injection every 6 weeks for 5 more cycles (24 weeks in total) injection. Occasionally, it will be administered as an infusion (drip).

You will have a routine blood test before the start of each treatment. Occasionally we may not be able to go ahead with your treatment until your blood counts are back to a safe level. If this happens, your chemotherapy may be delayed a week.

You may be advised to have a line fitted or an implantable/subcutaneous port (portacath) to aid the delivery of your intravenous treatment. This will be organised by the clinic if it is required. Your line or port needs to be removed after all your intravenous chemotherapy treatments have finished. If you have not received an appointment for this, please contact the procedure team on 0161 446 3916.

This treatment can have serious or possibly life-threatening side effects. It is very important that you report side effects straight away.

You are vulnerable to infection while you are having chemotherapy. Minor infections can become life-threatening in a matter of hours if left untreated. Symptoms of infection include fever, shivering, sweats, sore throat, diarrhoea, discomfort when you pass urine, cough or breathlessness. We recommend that you use a digital thermometer so you can check your temperature. You can buy one from your local chemist.

If you feel unwell, you have symptoms of an infection or your temperature is 37.5ºC or above, or below 36ºC, contact The Christie Hotline straight away on 0161 446 3658 (open 24 hours a day, 7 days a week).

Possible side effects

See the Cancer Research UK consent form.

You should have been given a copy of this consent form before you started treatment but it can also be found by visiting www.cancerresearchuk.org and searching ‘Consent forms for SACT (systemic anti-cancer therapy).

See 'SACT - a guide for patients and their carers'.

Contacts

If you have any general questions or concerns about your treatment, please ring:

  • Administration enquiries: 0161 918 7606/7610

  • Chemotherapy nurse: 0161 918 7171

  • Clinical trials unit: 0161 918 7663