Combination chemotherapy for breast cancer
By Mayo Clinic staffGiving two or more chemotherapy drugs at once may decrease the chance of the cancer returning and help women live longer. Drug combinations often are abbreviated using the first letter of each drug.
Combinations used frequently in adjuvant treatment of breast cancer are:
| Name | Description |
|---|---|
| AC | Doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan) |
| AC + docetaxel (AC + T) | Doxorubicin and cyclophosphamide followed by docetaxel (Taxotere) |
| AC + paclitaxel (AC + T) | Doxorubicin and cyclophosphamide followed by paclitaxel (Taxol) |
| AC + CMF | Doxorubicin and cyclophosphamide followed by cyclophosphamide, methotrexate (Trexall) and fluorouracil (Adrucil) |
| ACT | Doxorubicin, cyclophosphamide and paclitaxel |
| CAF | Cyclophosphamide, doxorubicin and fluorouracil |
| CEF | Cyclophosphamide, epirubicin and fluorouracil |
| CMF | Cyclophosphamide, methotrexate and fluorouracil |
| TC | Docetaxel and cyclophosphamide |
| TAC | Docetaxel, doxorubicin and cyclophosphamide |
* Letters in the abbreviated chemotherapy names may be derived from drug brand-names.
The class of drugs called taxanes (paclitaxel, docetaxel) has been studied in women with breast cancer that has spread to the lymph nodes. In women with estrogen receptor negative breast cancer that has spread to the lymph nodes, there's clear evidence that adding treatment with a taxane after AC chemotherapy reduces the chance of the cancer returning, and that these women live longer with this treatment. In women with estrogen receptor positive breast cancer that has spread to the lymph nodes, it's less clear whether added treatment with a taxane imparts any additional benefit — a point of some controversy among experts.
A newly defined adjuvant therapy option for women with HER2 breast cancer is chemotherapy combined with trastuzumab (Herceptin) — a drug that's used in the treatment of advanced (metastatic) breast cancer. Adding one year of trastuzumab to certain chemotherapy regimens significantly decreases risk of breast cancer recurrence and increases odds of overall survival — regardless of whether breast cancer recurs. Some studies have noted cardiac side effects in women taking trastuzumab. These effects, however, are often reversible, and may be no worse than the cardiac side effects of other adjuvant therapy regimens.
How will your doctor determine the right combination of chemotherapy drugs for you? He or she will consider a number of factors, including your general health and your own assessment of how well you can manage different short-term and long-term side effects. Ultimately, though, the decision is yours to make. Your doctor outlines the treatment options given your situation, and you choose which course of treatment you feel will be best for you.
