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:

You’ll be monitored (checked) every few months to see if the cancer is responding to treatment and if the side effects are manageable.

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 (abbreviation)

Brand name

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






IV drug



IV drug

Cyclophosphamide (C)


Pill or IV drug

Docetaxel (T)


IV drug

Doxorubicin (A)


IV drug

Epirubicin (E)


IV drug



IV drug

5-Fluorouracil (5FU or F)


IV drug



IV drug



IV drug

Liposomal doxorubicin


IV drug

Methotrexate (M)


Pill or IV drug

Paclitaxel (T)


IV drug

Paclitaxel, albumin bound (nab-paclitaxel)


IV drug



IV drug

Antibody-drug conjugates for metastatic breast cancer


Brand name

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

Ado-trastuzumab emtasine (T-DM1)


IV drug

Sacituzumab govitecan


IV drug

Trastuzumab deruxtecan


IV drug

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.

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.

Many clinical trials are available. Some are available as the first treatment for metastatic breast cancer. Others are for treatments 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.

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

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Metastatic Trial Search

The Metastatic Trial Search is a web-based 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.

Financial assistance

Costs related to metastatic breast cancer care can quickly become a financial burden. Dealing with finances and insurance can be overwhelming. Cancer or its treatments may also keep you or your partner from working as much as you used to, which can affect your income.

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

Learn about insurance plans and prescription drug assistance programs.

Learn about other financial 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

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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, cancer medications that are pills (oral cancer drugs) 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.


  • Do you need help with a metastatic breast cancer diagnosis? We’re here for you. The Komen Patient Care Center is your trusted, go-to source for timely, accurate breast health and breast cancer information, services and resources. Our navigators offer free, personalized support to patients, caregivers and family members, including education, emotional support, financial assistance, help accessing care and more. Get connected to a Komen navigator by contacting the Breast Care Helpline at 1-877-465-6636 or email to get started. All calls are answered Monday through Thursday, 9 a.m to 7 p.m. ET and Friday, 9 a.m. to 6 p.m. ET. Se habla español.
  • We offer an online support community through our closed Komen Metastatic Breast Cancer (Stage IV) Group. The Facebook group provides a place where those living with metastatic breast cancer, and those who love them, can find support, friendship and information. Click the link above or visit Facebook and search for Komen Metastatic Breast Cancer (Stage IV) Group and request to join.
  • Our free MBC Impact Series provides people living with metastatic breast cancer and their loved ones a safe, collaborative space to gather information related to metastatic breast cancer and discover practical resources to help make decisions for improved physical and emotional health. To learn more and register visit
  • Our Real Pink podcast series covers many relevant topics for people living with metastatic breast cancer and caregivers.
  • Our fact sheets, booklets and other education materials offer additional information.

Updated 03/24/24


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