Many of the drugs used to treat early breast cancer and locally advanced breast cancer are different than those used to treat metastatic breast cancer.
Chemotherapy drugs for early and locally advanced breast cancer
Figure 5.4 lists the most effective drugs for treating early and locally advanced breast cancer.
Figure 5.4: Chemotherapy drugs for early and locally advanced breast cancer
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Drug (abbreviation)
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Brand name
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Cyclophosphamide (C)
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Cytoxan
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Docetaxel (T)
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Taxotere
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Doxorubicin (A)
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Adriamycin
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Epirubicin (E)
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Ellence
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5-Fluorouracil (5FU or F)
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Adrucil
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Methotrexate (M)
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Maxtrex
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Paclitaxel (T)
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Taxol
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Chemotherapy drugs can be given one at a time, or in combination. Common drug combinations used to treat early and locally advanced breast cancer are listed below. Other combinations are also used.
Figure 5.5: Chemotherapy drug combinations for early and locally advanced breast cancer
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Drug (abbreviation)
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Drug combination
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AC
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Doxorubicin and cyclophosphamide
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| AC—>Paclitaxel (T) |
Doxorubicin and cyclophosphamide followed by paclitaxel
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AC—> Docetaxel (T)
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Doxorubicin and cyclophosphamide followed by docectaxel
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TAC
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Docectaxel, doxorubicin and cyclophosphamide
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TC
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Cyclophosphamide and docetaxel
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CMF
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Cyclophosphamide, methotrexate (Rheumatrex) and 5-fluorouracil
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TCH
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Docetaxel, carboplatin and trastuzumab (Herceptin)*
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| ACTH |
Doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab* |
| *Only used for HER2/neu-positive breast cancers. TCH is not used without trastuzumab. |
HER2/neu-positive tumors
All breast cancers are tested for hormone receptor status and HER2/neu status. These tumor characteristics guide treatment (learn more). If a tumor is HER2/neu-positive (HER2/neu+), the targeted therapy drug trastuzumab (Herceptin) is included in the chemotherapy regimen. Trastuzumab is not used to treat HER2/neu-negative (HER2/neu-) cancers. Trastuzumab is given for one year. It is usually started with chemotherapy, and then continued after the chemotherapy has ended.
Most studies on HER2/neu+ breast cancers have used the AC regimen followed by a taxane drug (paclitaxel (Taxol) or docetaxel (Taxotere)) and added the trastuzumab during the taxane treatment (ACTH).
Learn more about trastuzumab.
Chemotherapy drugs for metastatic breast cancer
Some drugs and drug combinations used to treat early breast cancer are also used to treat metastatic cancer. Figure 5.6 lists the most common chemotherapy drugs (used alone or in combination) to treat metastatic breast cancer. This list is not exhaustive and does not include drugs that are rarely used or no longer in use.
Figure 5.6: Chemotherapy drugs for metastatic breast cancer
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Drug (abbreviation)
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Brand name
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Capecitabine
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Xeloda
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Carboplatin
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Paraplatin
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Cisplatin
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Platinol
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Cyclophosphamide (C)
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Cytoxan
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Docetaxel (T)
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Taxotere
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Doxorubicin (A)
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Adriamycin
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Epirubicin (E)
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Ellence
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Eribulin mesylate
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Halaven
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5-Fluorouracil (5FU or F)
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Adrucil
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Gemcitabine
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Gemzar
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Ixabepilone
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Ixempra
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Liposomal doxorubicin
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Doxil
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Methotrexate (M)
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Maxtrex
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Paclitaxel (T)
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Taxol
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Paclitaxel, albumin bound
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Abraxane
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Vinorelbine
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Navelbine |
To learn more about a specific chemotherapy drug, visit the National Institutes of Health’s Medline Plus website.
Prescription drug assistance
Chemotherapy drug costs can quickly become a financial burden for you and your family. Medicare and many insurance providers offer prescription drug plans. One may already be included in your policy or you may be able to buy an extra plan for prescriptions.
Some drugs are off-patent and a generic form may be available. Generic drugs are cheaper than the name brands, but are just as effective. You may also qualify for assistance from programs that help with drug costs or offer low-cost or free prescriptions.
Learn more about insurance plans and prescription drug assistance programs.
Komen Advocacy Alliance position in oral chemotherapy parity
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Although oral chemotherapy is generally covered under a prescription drug plan, you may have more out-of-pocket costs than with intravenous (IV) chemotherapy. These costs can be high when there is no generic form of the drug. Some people are faced with out-of-pocket costs of hundreds or even thousands of dollars a month.
The Komen Advocacy Alliance believes health decisions should be made between you and your health care provider and should not be constrained by financial factors. People fighting cancer should be protected from high out-of-pocket medical costs that could lead to financial hardship.
The Komen Advocacy Alliance supports efforts at the state and federal level to require group and individual health insurance coverage and group health plans to provide coverage for oral chemotherapy on terms no less favorable than the coverage for IV chemotherapy. At the same time, we must ensure health insurers are not allowed to reduce the coverage of IV chemotherapy.
Learn more about the Komen Advocacy Alliance.
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Updated 04/15/13
