Clinician draft — consent discussion support. This is not a signed consent form or treatment authorisation. Review and individualise the content, then complete the approved local consent process.
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1. Treatment and purpose Pembrolizumab 200 mg + carboplatin AUC 5 / paclitaxel → AC · NCCP 00857 v3
Four 21-day cycles: paclitaxel on Days 1, 8 and 15; carboplatin AUC 5 on Day 1. Pembrolizumab 200 mg on Day 1 of each cycle (every three weeks). Four further cycles (cycles 5–8): doxorubicin and cyclophosphamide on Day 1 every 21 days. Pembrolizumab 200 mg on Day 1 of each AC cycle. The operation is planned after recovery; the pathology result helps decide the next treatment. After surgery: pembrolizumab 200 mg every 21 days for nine doses OR 400 mg every 42 days for five doses. These are alternative schedules, not consecutive courses. Progression preventing definitive surgery or unacceptable pembrolizumab toxicity changes this plan; postoperative treatment is not automatic.
Review the treatment journey, tests and phase transitions with the patient.
Individual aim, expected benefit, uncertainty and assessment plan
Reasonable alternatives, including supportive care and not proceeding with this regimen
2. Risks and supportive care Pembrolizumab · Immunotherapy The immune system can also inflame healthy organs. New cough, diarrhoea, unusual weakness, severe headache, thirst or a spreading rash need prompt advice. Effects can start during treatment or after it finishes.
Carboplatin · Platinum chemotherapy Keep blood-test appointments. Fever, unusual bleeding, repeated vomiting or infusion symptoms need prompt advice.
Paclitaxel · Taxane chemotherapy Report tingling or numbness before the next weekly dose, especially if it affects walking or hand use. Tell the nurse immediately about flushing, chest or throat tightness, itching, dizziness or breathing changes during infusion.
Doxorubicin · Anthracycline chemotherapy Report pain or burning at the infusion site immediately. New breathlessness or chest symptoms need prompt review. Red urine for a short time can be a drug-colour effect; pain, clots or persistent bleeding still need advice.
Cyclophosphamide · Alkylating chemotherapy Use the prescribed anti-sickness and hydration plan. Report fever, painful urination or blood in the urine.
These are selected discussion prompts, not a complete risk list. Discuss serious, potentially life-threatening and lasting effects; tailor the conversation to comorbidities and the patient’s priorities. Discuss treatment aim, alternatives, expected benefit, common and serious risks, fertility, pregnancy precautions and the full sequence. Immune effects can be delayed or permanent; explain the postoperative option and when it is not appropriate. The treating team completes the individual consent discussion; this guide does not determine personal benefit.
Additional material risks, individual concerns and agreed supportive plan