Acute Oncology Service
SACTCheck · treatment passport
Pembrolizumab 200 mg + carboplatin AUC 5 / paclitaxel → AC
A record of what you experience
One cycle per page. Each medicine has its own symptom table. Mark the worst symptoms since your last review, when they occurred and what they stopped you doing. Overlapping symptoms can be recorded under more than one medicine; you do not have to identify the cause.
These are patient-language severity prompts, not a validated questionnaire or a formal CTCAE grading tool. Your team assigns the clinical grade. Serious symptoms override the columns: call without waiting to decide a severity level.
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. 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.
The four pages are reusable recording sheets, not a prescribed four-cycle course. Ask for additional sheets as needed.
Emergency: 112 / 999. Severe breathing difficulty, collapse, seizure or severe chest pain needs emergency help.
Contact oncology immediately for temperature ≥37.5°C or ≤36°C, shivering or suddenly feeling unwell, even with a normal temperature. Follow your own hospital’s instructions. If you cannot reach the team, seek urgent medical assessment.
Ask for medical oncology
Other hospitals: use the numbers your team provides.
Your own hospital / contact instructions:
https://sactcheck.com/patient/00857/
Full patient information, sources and visual timeline. No identifiers are encoded.
Source reconciled; independent oncology, pharmacy and patient/PPI review pending
NCCP 00857 v3 · one cycle, one page
Pembrolizumab 200 mg + carboplatin AUC 5 / paclitaxel → AC
Cycle number: __________ Start date: __________ Next review: __________
Phase 1 · reusable record · copy this sheet for another cycle of the same phase.
Pembrolizumab · Immunotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Skin / nail changes | □ None | □ Mild change: report | □ Pain or daily tasks affected: call | □ Spreading infection or blistering: urgent review | □ Severe illness / collapse: emergency help |
Carboplatin · Platinum chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Nausea | □ None | □ Queasy but eating and drinking | □ Intake reduced: contact the team | □ Unable to maintain intake: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Bleeding / bruising | □ None | □ New small bruise / brief bleed: report | □ Repeated bleeding: call today | □ Bleeding that will not stop: urgent help | □ Heavy bleeding / collapse: 112/999 |
Paclitaxel · Taxane chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Numbness / tingling | □ None | □ Mild change; usual tasks unaffected | □ Limits buttons, writing or walking: call | □ Washing, dressing or walking difficult: urgent review | □ Sudden major weakness / paralysis: emergency help |
| Muscle / joint pain | □ None | □ Mild aches; normal activity | □ Pain limits tasks / sleep: call | □ Pain limits self-care: urgent review | □ Sudden severe deterioration: emergency help |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Mouth soreness / ulcers | □ None | □ Mild soreness; eating normally | □ Painful; soft food needed: call | □ Cannot eat / drink enough: urgent review | □ Major breathing difficulty: 112/999 |
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
| Nausea | □ None | □ Queasy but eating and drinking | □ Intake reduced: contact the team | □ Unable to maintain intake: urgent review | □ Collapse / severe dehydration: 112/999 |
Dates / doses missed or changed / symptoms affecting daily life / questions:
Red flags override the table. Fever, shivers, suddenly unwell, chest symptoms or inability to drink: seek prompt advice. Severe breathing difficulty, collapse or severe chest pain: 112 / 999.
NCCP 00857 v3 · one cycle, one page
Pembrolizumab 200 mg + carboplatin AUC 5 / paclitaxel → AC
Cycle number: __________ Start date: __________ Next review: __________
Phase 2 · reusable record · copy this sheet for another cycle of the same phase.
Pembrolizumab · Immunotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Skin / nail changes | □ None | □ Mild change: report | □ Pain or daily tasks affected: call | □ Spreading infection or blistering: urgent review | □ Severe illness / collapse: emergency help |
Doxorubicin · Anthracycline chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Mouth soreness / ulcers | □ None | □ Mild soreness; eating normally | □ Painful; soft food needed: call | □ Cannot eat / drink enough: urgent review | □ Major breathing difficulty: 112/999 |
| Nausea | □ None | □ Queasy but eating and drinking | □ Intake reduced: contact the team | □ Unable to maintain intake: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
Cyclophosphamide · Alkylating chemotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Nausea | □ None | □ Queasy but eating and drinking | □ Intake reduced: contact the team | □ Unable to maintain intake: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Urinary symptoms | □ Usual pattern | □ Mild change: report | □ Pain or frequent urination: call | □ Cannot pass urine / marked bleeding: urgent review | □ Collapse or severe illness: 112/999 |
Dates / doses missed or changed / symptoms affecting daily life / questions:
Red flags override the table. Fever, shivers, suddenly unwell, chest symptoms or inability to drink: seek prompt advice. Severe breathing difficulty, collapse or severe chest pain: 112 / 999.
NCCP 00857 v3 · one cycle, one page
Pembrolizumab 200 mg + carboplatin AUC 5 / paclitaxel → AC
Cycle number: __________ Start date: __________ Next review: __________
After surgery · pembrolizumab record · copy this sheet for another cycle of the same phase.
Pembrolizumab · Immunotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Skin / nail changes | □ None | □ Mild change: report | □ Pain or daily tasks affected: call | □ Spreading infection or blistering: urgent review | □ Severe illness / collapse: emergency help |
Dates / doses missed or changed / symptoms affecting daily life / questions:
Red flags override the table. Fever, shivers, suddenly unwell, chest symptoms or inability to drink: seek prompt advice. Severe breathing difficulty, collapse or severe chest pain: 112 / 999.
NCCP 00857 v3 · one cycle, one page
Pembrolizumab 200 mg + carboplatin AUC 5 / paclitaxel → AC
Cycle number: __________ Start date: __________ Next review: __________
After surgery · additional record · copy this sheet for another cycle of the same phase.
Pembrolizumab · Immunotherapy
| Symptom | None | Mild | Moderate / call | Severe / urgent | Emergency signs |
|---|---|---|---|---|---|
| Diarrhoea | □ Usual pattern | □ Up to 3 extra stools above normal | □ 4–6 extra stools/day or at night: call | □ 7+ extra stools/day or dehydration: urgent review | □ Collapse / severe dehydration: 112/999 |
| Fatigue | □ Usual energy | □ Tiredness improves with rest | □ Rest does not help; usual tasks affected: call | □ Self-care difficult: urgent review | □ Collapse: 112/999 |
| Skin / nail changes | □ None | □ Mild change: report | □ Pain or daily tasks affected: call | □ Spreading infection or blistering: urgent review | □ Severe illness / collapse: emergency help |
Dates / doses missed or changed / symptoms affecting daily life / questions:
Red flags override the table. Fever, shivers, suddenly unwell, chest symptoms or inability to drink: seek prompt advice. Severe breathing difficulty, collapse or severe chest pain: 112 / 999.