There definitely was a cumulative effect,but for me it was more that side effects lasted longer.For instance I felt fatigued for an extra couple of days,but nothing too different.I had a skin rash the second time,that I didn't have the first round,but not much else.However I definitely felt more confident the second round,and I remember that when a lady in the chair next to me told me that it was her first chemo,I found myself giving advice like Id been doing it all my life!!,Haha.Take care,it will all be over soon.:) Robynxox