What are the third-generation regimens for the treatment of stage I, IIA, IIB, or IIIA (T3N1M0) HER2/neu-negative breast cancer?

Updated: Apr 23, 2020
  • Author: Joseph A Sparano, MD; Chief Editor: John V Kiluk, MD, FACS  more...
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Answer

Third-generation regimens

Third-generation regimens have been shown to be more effective than some second-generation regimens and include both taxanes and anthracyclines. The regimens are as follows:

  • AC-paclitaxel: Doxorubicin 60 mg/m2 IV plus  cyclophosphamide 600 mg/m2 IV on day 1 every 3 wk for four cycles, followed by paclitaxel 80 mg/m2 by 1-h IV infusion weekly for 12 wk (more effective than AC) [9] or

  • TAC: Docetaxel 75 mg/m2 IV plus  doxorubicin 50 mg/m2 IV plus  cyclophosphamide 500 mg/m2 IV on day 1 every 3 wk for six cycles (more effective than FAC; CSF support recommended) [19, 20] or

  • FEC-docetaxel: 5-FU 500 mg/m2 IV plus  epirubicin 100 mg/m2 IV plus  cyclophosphamide 500 mg/m2 IV on day 1 every 3 wk for three cycles, followed by docetaxel 100 mg/m2 IV every 3 wk for three cycles (more effective than six cycles of FEC) [21] or

  • FEC-paclitaxel: 5-FU 600 mg/m2 IV plus  epirubicin 90 mg/m2 IV plus  cyclophosphamide 600 mg/m2 IV on day 1 every 3 wk for four cycles, followed by 3 wk of no treatment; followed by paclitaxel 100 mg/m2 IV weekly for eight cycles (more effective than six cycles of FEC) [22]


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