Learn about chemotherapy drugs for:

• Early and locally advanced breast cancer
• Metastatic breast cancer 

Chemotherapy 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
Drug (abbreviation)	Brand name	Pill or IV drug (given by vein through an IV)
Capecitabine	Xeloda	Pill
Carboplatin (C)	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.

Your schedule depends on the combination of drugs used for treatment.

Common chemotherapy drug combinations

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
HER2-negative breast cancers
Drug (abbreviation)	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
HER2-positive breast cancers
Drug (abbreviation)	Drug combination
TCH*	Docetaxel, carboplatin and trastuzumab
TCHP*	Docetaxel, carboplatin, trastuzumab and pertuzumab
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
*Only used for HER2-positive breast cancers. TCH, TCHP, TH and THP are not used without trastuzumab.

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 also included. Pertuzumab (Perjeta) can be combined with trastuzumab (when given through an IV), and neratinib (Nerlynx) can be given after trastuzumab.

These drugs are not used to treat HER2-negative cancers.

Trastuzumab (with or without pertuzumab) is given by vein (through an IV) or by injection every 3 weeks for one year. It’s usually started with chemotherapy, and then continued after the chemotherapy has ended.

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

Chemotherapy drugs for metastatic breast cancer

Figure 5.6 lists the most common chemotherapy drugs (used alone or in combination) to treat metastatic breast cancer.

Figure 5.6: Chemotherapy drugs for metastatic breast cancer*
Drug (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

 

*This list is not exhaustive and does not include drugs rarely used or no longer in use.

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

Learn more about treatment for metastatic breast cancer.

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. 

Learn more about insurance plans and prescription drug assistance programs.

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

Although most chemotherapy is given by vein (through an IV), a few chemotherapy drugs are pills (oral chemotherapy). Insurance coverage of oral cancer drugs Insurance policies haven’t kept pace with treatment advances. IV chemotherapy is usually covered under a health insurance plan’s medical benefit, but oral chemotherapy is usually covered under a plan’s prescription drug benefit. As a result, people often find themselves facing high out-of-pocket costs when filling prescriptions for oral chemotherapy. Sometimes this can cost thousands of dollars a month. The impact of high drug costs High prescription drug costs 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 chemotherapy than oral chemotherapy. 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 chemotherapy as they do for IV chemotherapy. This would help ensure patients have access to affordable, appropriate treatment. Take action Ask your U.S. representative to co-sponsor the Cancer Drug Parity Act.