The Who, What, Where, When and Sometimes, Why.

Chemotherapy Drugs for Early Breast Cancer

Learn about chemotherapy drugs for:

Chemotherapy for early and locally advanced breast cancer

The table below lists the most effective drugs for treating early and locally advanced breast cancer. 

Chemotherapy drugs for early and locally advanced breast cancer

Drug (abbreviation)

Brand name

Pill or IV drug (given by vein through an IV)

5-fluorouracil (5FU)

Various brand names

IV drug

Capecitabine

Xeloda

Pill

Carboplatin

Paraplatin

IV drug

Cyclophosphamide (C)

Cytoxan

Pill or IV drug

Docetaxel (T)

Taxotere

IV drug

Doxorubicin (A)

Adriamycin

IV drug

Epirubicin (E)

Ellence

IV drug

Methotrexate (M)

Various brand names

Pill or IV drug

Paclitaxel (T)

Taxol

IV drug

Chemotherapy schedule

Chemotherapy is usually given over 3-6 months. It’s given in cycles, with days or weeks off between treatments. This gives your body a chance to recover between treatments.

Your schedule will depend on the combination of drugs given.

Common chemotherapy drug combinations

The table below lists common drug combinations used to treat early and locally advanced breast cancer. Other combinations are also used.

Chemotherapy drug combinations for early and locally advanced breast cancer

HER2-negative breast cancers

Drug (abbreviation)

Chemotherapy drug combination

AC

Doxorubicin and cyclophosphamide

AC—>Paclitaxel (T)

Doxorubicin and cyclophosphamide followed by paclitaxel

AC—> Docetaxel (T)

Doxorubicin and cyclophosphamide followed by docetaxel

TAC

Docetaxel, doxorubicin and cyclophosphamide

TC

Cyclophosphamide and docetaxel

CMF

Cyclophosphamide, methotrexate and 5-fluorouracil

EC

Epirubicin and cyclophosphamide

Paclitaxel and carboplatin

Paclitaxel and carboplatin

Docetaxel and carboplatin

Docetaxel and carboplatin

Pembrolizumab* and chemotherapy (KEYNOTE)

Pembrolizumab and chemotherapy, usually with paclitaxel and carboplatin, followed by doxorubicin and cyclophosphamide

* Pembrolizumab is an immunotherapy drug and is only used in combination with chemotherapy.

HER2-positive breast cancers

Drug (abbreviation)

Chemotherapy drug combination

TCH†

Docetaxel, carboplatin and trastuzumab (Herceptin)

TCHP†

Docetaxel, carboplatin, trastuzumab and pertuzumab (Perjeta)

AC—>Paclitaxel (T) H

Doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab

AC—>Paclitaxel (T) HP

Doxorubicin and cyclophosphamide followed by paclitaxel, trastuzumab and pertuzumab

TH†

Paclitaxel and trastuzumab

THP†

Paclitaxel, trastuzumab and pertuzumab

Ado-trastuzumab emtansine (T-DM1)††

Ado-trastuzumab emtansine

† TCH, TCHP, TH and THP are not used without the HER2-targeted therapy drug trastuzumab.

†† T-DM1 is a HER2 antibody-drug conjugate. It consists of trastuzumab (T) and a chemotherapy drug called DM1.

To learn more about a specific chemotherapy drug, visit the National Institutes of Health’s Medline Plus website.

HER2-positive tumors

All breast cancers are tested for HER2 status to help guide treatment.

If a tumor is HER2-positive, the HER2-targeted therapy drug trastuzumab (Herceptin) is included in the chemotherapy regimen. Sometimes other drugs that target HER2 are used.

Learn more about trastuzumab and other HER2-targeted therapies for early breast cancer.

Learn more about other drug therapies for early breast cancer.

Antibody-drug conjugates

Special antibody therapies are designed to target certain cancer cells. Antibody-drug conjugates are a combination of an antibody therapy and a chemotherapy drug.

For example, the antibody-drug conjugates ado-trastuzumab emtasine (Kadcyla, T-DM1) combines the HER2-targeted therapy drug trastuzumab and the chemotherapy drug DM1. This allows the targeted delivery of the chemotherapy to HER2-positive cancer cells.

Prescription drug assistance

Chemotherapy drug costs can quickly become a financial burden for you and your family.

Medicare and many insurance companies 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 may have a generic form. Generic drugs cost less than the name brands but are just as effective.

You may also qualify for programs that help with drug costs or offer low-cost or free prescriptions. 

Many cancer centers have financial counselors who can discuss insurance and cost coverage with you.

Learn more about insurance plans and prescription drug assistance programs.

Komen Financial Assistance Program

Susan G. Komen® created the Komen Financial Assistance Program to help those struggling with the costs of breast cancer treatment by providing financial assistance to eligible individuals.

To learn more about this program and other helpful resources, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org.

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Susan G. Komen®‘s position on fairness in oral cancer drug coverage

Insurance coverage of oral cancer drugs

Cancer medications given through an IV into a vein or by an injection (under the skin or into a muscle) are usually covered under a health insurance plan’s medical benefit. However, oral cancer drugs (cancer medications that are pills) are usually covered under a health insurance plan’s prescription drug benefit.

As a result, people often find themselves facing high out-of-pocket costs when filling prescriptions for oral cancer drugs. Sometimes these costs can be thousands of dollars a month.

The impact of high cost-sharing

High prescription drug costs and the resulting out-of-pocket burden on patients are a barrier to care. They can prevent people from getting the medications prescribed by their health care providers.

No one should be forced to get less appropriate treatment because an insurer gives more coverage for IV and injectable drugs than for pills.

Efforts to increase fairness in drug coverage

Komen supports state and federal efforts to require insurers to provide the same or better coverage for oral cancer drugs as they do for IV and injectable cancer drugs. This would help make sure patients have access to affordable, appropriate treatment.

Become a Komen Advocacy Insider

Sign up to be a Komen Advocacy Insider and get informed when action is needed on drug coverage issues at the state or national level.

 Updated 04/07/24