Chemotherapy for Metastatic Breast Cancer
For people with metastatic breast cancer, chemotherapy is used to kill cancer cells that have spread from the breast to other parts of the body.
Chemotherapy can increase survival and reduce symptoms related to the cancer.
Chemotherapy and metastatic breast cancer treatment
Chemotherapy is the preferred treatment for metastatic breast cancers that are:
- Hormone receptor-negative
- Hormone receptor-positive, but no longer respond to hormone therapy
- HER2-positive (in combination with HER2-targeted therapy)
You’ll be monitored (checked) every few months to see if the cancer is responding to treatment.
If the first chemotherapy drug (or combination of drugs) stops working and the cancer begins to grow again, a second or third drug can be used.
The use of each chemotherapy drug (or combination of drugs) for metastatic breast cancer is called a “line” of treatment. For example, the first chemotherapy used is called the “first-line” treatment and the second is called the “second-line” treatment.
With each line of treatment, it becomes less likely the cancer will shrink. And if the cancer does shrink, it’s often controlled for a shorter period of time with each new drug.
It’s common to get multiple lines of chemotherapy regimens (often 4 or more) over the course of treatment for metastatic breast cancer.
Learn more about how metastatic breast cancer is monitored.
Learn more about chemotherapy.
Learn about going through chemotherapy, including how chemotherapy drugs are given.
Learn more about treatment for metastatic breast cancer.
Learn about emerging areas in treatment for metastatic breast cancer.
Chemotherapy drugs commonly used to treat metastatic breast cancer
The table below lists the most common chemotherapy drugs (used alone or in combination) to treat metastatic breast cancer. This list isn’t exhaustive and doesn’t include drugs rarely used or no longer in use.
The table also includes the most common antibody-drug conjugates. These drugs are made of an antibody therapy designed to target certain cancer cells and a chemotherapy drug. Combining these into one drug allows the targeted delivery of the chemotherapy to specific cancer cells.
Chemotherapy drugs for metastatic breast cancer | ||
Drug name (abbreviation) | Brand name | Pill or IV drug (given by vein through an IV) |
Capecitabine* | Xeloda | Pill |
Carboplatin | Paraplatin | IV drug |
Cisplatin | Platinol | IV drug |
Cyclophosphamide (C) | Cytoxan | Pill or IV drug |
Docetaxel (T) | Taxotere | IV drug |
Doxorubicin (A) | Adriamycin | IV drug |
Epirubicin (E) | Ellence | IV drug |
Eribulin | Halaven | IV drug |
5-Fluorouracil (5FU or F)* | Adrucil | IV drug |
Gemcitabine | Gemzar | IV drug |
Ixabepilone | Ixempra | IV drug |
Liposomal doxorubicin | Doxil | IV drug |
Methotrexate (M) | Maxtrex | Pill or IV drug |
Paclitaxel (T) | Taxol | IV drug |
Paclitaxel, albumin bound (nab-paclitaxel) | Abraxane | IV drug |
Vinorelbine | Navelbine | IV drug |
Antibody-drug conjugates for metastatic breast cancer | ||
Drug name |
Brand name |
Pill or IV drug (given by vein through an IV) |
Kadcyla |
IV drug |
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Datroway |
IV drug |
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Trodelvy |
IV drug |
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Enhertu |
IV drug |
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*Capecitabine and 5-fluorouracil aren’t given to people who have a DPYD gene mutation because they can have a serious harmful reaction to these drugs. So, if capecitabine or 5-fluorouracil is being considered in your treatment plan, you’ll have genetic testing (a blood test) to see if you have a DPYD gene mutation. DPYD mutations are rare. |
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To learn more about a specific drug, visit the National Institutes of Health’s Medline Plus website.
Side effects of chemotherapy
Chemotherapy has many common side effects, but they vary from drug to drug.
Let your health care team know about any side effects you’re having. They may be able to treat or prevent many of the side effects. Or they may be able to change your treatment plan to try to reduce them.
Your health care team will also check in with you regularly to make sure your side effects are manageable.
Learn about easing worries over side effects of chemotherapy.
Learn about short-term side effects of chemotherapy.
Learn about long-term side effects of chemotherapy.
Ashley Fernandez, living with metastatic breast cancer
“What keeps me going is my new normal. My life with cancer is completely different, I know I have it and I live with it every single day but it doesn’t take over every single day.”
Treatment guidelines for metastatic breast cancer
Although the exact treatment for metastatic breast cancer varies from person to person, guidelines help make sure high-quality care is given. These guidelines are based on the latest research and agreement among experts.
The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) are respected organizations that regularly review and update their guidelines.
In addition, the National Cancer Institute (NCI) has treatment overviews.
Talk with your health care team about which treatment guidelines they follow.
Clinical trials
Clinical trials offer the chance to try new treatments and possibly benefit from them. They can also study other parts of care, such as ways to manage side effects. We encourage you to talk with your oncologist and consider joining a clinical trial if there’s one right for you.
Some clinical trials are available as the first step in treating metastatic breast cancer. Others are for later in the disease course.
Consider joining a clinical trial when you’re newly diagnosed, when your oncologist is considering changing treatments or when there are limited treatment options.
Read our blogs:
- Four Things to Know About Clinical Trials When You’re Diagnosed with Breast Cancer
- How Do You Thank Someone for Time
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Susan G. Komen® Patient Care Center |
If you or a loved one needs information or resources about clinical trials, the Patient Care Center can help. Contact the Komen Breast Care Helpline at 1-877-465-6636 or email clinicaltrialinfo@komen.org. Se habla español. |
Metastatic Trial Search |
The Metastatic Trial Search is an online clinical trial matching tool that can help you find clinical trials that fit your needs. You can also register to receive Trial Alerts. |
Learn more about clinical trials for people with metastatic breast cancer.
Learn what Komen is doing to help people find and participate in breast cancer clinical trials, including trials supported by Komen.
Learn how Komen-funded research is improving treatment for breast cancer.
Financial assistance
Costs related to breast cancer treatment can quickly become a financial burden for you and your family. Dealing with finances and insurance can be overwhelming.
Many hospitals have financial counselors who can discuss insurance and cost coverage with you. They may be able to arrange a payment plan for hospital-related costs.
You may qualify for financial assistance from federal, state or local programs. A financial counselor or social worker at your hospital can help you learn about financial assistance programs.
Learn about other financial assistance programs.
Prescription drug assistance
Most chemotherapy drugs are given through an IV into a vein, so they are covered under your health insurance plan’s medical benefit. However, some chemotherapy drugs are pills and are covered under your plan’s prescription drug benefit. This means there are usually out-of-pocket costs, which can add up over time.
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.
Many hospitals have financial counselors who can discuss insurance and cost coverage with you.
You may qualify for programs that help with drug costs or offer low-cost or free prescription drugs. A financial counselor or social worker at your hospital can help you learn about these programs.
Learn about insurance plans and prescription drug assistance programs.
Learn about other financial assistance programs.
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Komen Financial Assistance Program |
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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 Patient Care Center at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org. Se habla español. Learn about other financial assistance programs. |
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Susan G. Komen®‘s position on fairness in oral cancer drug coverage |
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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 health 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 oral drug coverage parity at the state or national level. |
SUSAN G. KOMEN® METASTATIC BREAST CANCER SUPPORT RESOURCES |
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Updated 03/12/26
This content is regularly reviewed by an expert panel including researchers, practicing clinicians and patient advocates.
