Treatment protocols for breast cancer

INTRODUCTION — The following material represents a subset of chemotherapy and immunotherapy regimens that are used for the treatment of patients with breast cancer, both in the adjuvant and neoadjuvant settings. This is not an exhaustive list; it includes regimens that are considered by the authors and editors to be commonly used and important for the care of patients with breast cancer. Additional regimens may be added over time, particularly as treatment for breast cancer evolves.

This topic review is intended to provide only a listing of chemotherapy and immunotherapy regimens. It does not address the appropriate context for use of these regimens in the care of patients with breast cancer. Clinicians should refer to the individual disease-oriented topic reviews that discuss the use of these protocols in appropriate clinical situations:

●(See "Selection and administration of adjuvant chemotherapy for HER2-negative breast cancer".)

●(See "Adjuvant systemic therapy for HER2-positive breast cancer".)

●(See "General principles of neoadjuvant management of breast cancer".)

●(See "Endocrine therapy resistant, hormone receptor-positive, HER2-negative advanced breast cancer".)

●(See "Systemic treatment for HER2-positive metastatic breast cancer".)

These tables are provided as examples of how to administer these regimens; there may be other acceptable methods. All chemotherapy and immunotherapy regimens must be administered by clinicians who are trained in the use of chemotherapy and immunotherapy. The clinician is expected to use his or her independent medical judgment in the context of individual circumstances to make adjustments, as necessary.

REGIMENS

Regimens for HER2-negative breast cancer (including HER2-low cancers)

TC (docetaxel plus cyclophosphamide) —  (table 1)

AC-T, dose dense (doxorubicin plus cyclophosphamide followed by paclitaxel) —  (table 2)

AC (doxorubicin plus cyclophosphamide) —  (table 3)

TAC (docetaxel, doxorubicin, and cyclophosphamide) —  (table 4)

Oral CMF (oral cyclophosphamide plus methotrexate and fluorouracil) —  (table 5)

IV CMF (IV cyclophosphamide plus methotrexate and fluorouracil) —  (table 6)

FEC (fluorouracil, epirubicin, plus cyclophosphamide) —  (table 7)

FEC followed by weekly paclitaxel —  (table 8)

FEC followed by weekly docetaxel —  (table 9)

Trastuzumab deruxtecan —  (table 10)

Regimens for HER2-positive breast cancer

TH (paclitaxel and trastuzumab) —  (table 11)

TCH (docetaxel, carboplatin, and trastuzumab) —  (table 12)

TCHP (trastuzumab, pertuzumab, carboplatin, and docetaxel) —  (table 13)

AC-TH (doxorubicin plus cyclophosphamide followed by paclitaxel plus trastuzumab) —  (table 14)

AC-THP (doxorubicin and cyclophosphamide followed by paclitaxel, trastuzumab, and pertuzumab) —  (table 15)

FEC-THP (FEC followed by docetaxel, pertuzumab, and trastuzumab) —  (table 16)

THP-FEC-H (neoadjuvant docetaxel, trastuzumab, and pertuzumab followed by adjuvant FEC, followed by trastuzumab —  (table 17)

THP (docetaxel, trastuzumab, and pertuzumab) —  (table 18)

Ado-trastuzumab emtansine —  (table 19)

SOCIETY GUIDELINE LINKS — Links to society and government-sponsored guidelines from selected countries and regions around the world are provided separately. (See "Society guideline links: Breast cancer".)

ACKNOWLEDGMENT — The UpToDate editorial staff acknowledges Scott M Wirth, PharmD, BCOP, who contributed to an earlier version of this topic review.