What is the drug for second line chemotherapy?
Patient: hello doctor, Erpr negative and herceptin negative patient of IDC with node – ve, received first line chemotherapy now having multipal secondaries in  lungs leaver , meadiastinum and bones with multi centric disease-  please suggest me drug of choice for second line chemotherapy. Doctor: If its been more than 6 months since your last chemo the first line chemo can be reused.Based on what you have recieved initially the second line is decided.If your tolerance is poor a single agent therapy using gemcitabine or cyclophos or doxo.If tolerance is good a combination like cyclo doxo 5fu can be used.Since you have bone mets monthly zoledronic or denosumab helps.Usually with extensive disease single agent therapy along with denosumab or zoledronic is preferred.The decision varies from patient to patient.