Appendix 2. Adjuvant Regimens. AC doxorubin 60 mg/m 2 every 3 weeks x 4 cycles Cyclophosphamide 600 mg/m 2

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Belinda White
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Appendix 2 Adjuvant Regimens AC doxorubin 60 mg/m 2 every 3 weeks x 4 cycles Cyclophosphamide 600 mg/m 2 CMF IV cyclophosphamide 600 mg/m 2 days 1 & 8 every 4 weeks methotrexate 40 mg/m 2 for 6

1 Appendix 2 Adjuvant Regimens AC doxorubin 60 mg/m 2 every 3 weeks x 4 cycles Cyclophosphamide 600 mg/m 2 CMF IV cyclophosphamide 600 mg/m 2 days 1 & 8 every 4 weeks methotrexate 40 mg/m 2 for 6 cycles fluorouracil 600 mg/m 2 CMF oral cyclophosphamide 100 mg/m 2 po daily for 14 days every 4 weeks x 6 cycles methotrexate 40 mg/m 2 days 1 & 8 fluorouracil 600 mg/m 2 days 1 & 8 Docetaxel Carboplatin with Trastuzumab (TCH) docetaxel 75 mg/m 2 IV day 1 every 3 weeks x 6 cycles carboplatin AUC = 6 IV day 1 8 mg/kg IV cycle 1 (LD); then, 6mg/kg (MD) for cycles 2 to 6 Docetaxel Cyclophosphamide (TC) docetaxel 75 mg/m 2 IV day 1 every 3 weeks x 4 cycles cyclophosphamide 600 mg/m 2 IV day 1 Docetaxel Cyclophosphamide with Trastuzumab (TC plus H) docetaxel 75 mg/m 2 IV day 1 every 3 weeks x 4 cycles cyclophosphamide 600 mg/m 2 IV day 1 8 mg/kg IV cycle 1 (LD); then, 6mg/kg (MD) for cycles 2 to 4 FE 100C fluorouracil 500 mg/m 2 IV day 1 every 3 weeks x 6 cycles epirubicin 100 mg/m 2 IV day 1 cyclophosphamide 500 mg/m 2 IV day 1

2 FEC-Doc fluoruouracil 500 mg/m 2 IV day 1 every 3 weeks x 3 cycles epriubicin 100 mg/m 2 IV day 1 cyclophosphamide 500 mg/m 2 IV day 1 -followed bydocetaxel 100mg/m 2 IV day 1 every 3 weeks x 3 cycles FEC-Doc with Trastuzumab as per FEC-Doc plus 8mg/kg (LD) with cycle 1 of docetaxel; followed by 6 mg/kg (MD) for the next 2 cycles AC-T AC x 4 cycles followed by.. paclitaxel 80 mg/m 2 IV day1 weekly x 12 weeks AC-T + Trastuzumab AC-T with starting concurrently with paclitaxel 4 mg/kg cycle1 (LD); then, 2 mg/kg (MD) for cycles 2-12, then as per maintenance Trastuzumab (maintenance) following chemotherapy, is to continue to a maximum of 1 year (equivalent of 18 doses given every 3 weeks) over a maximum of 14 months from the 1 st dose of.

3 Adjuvant Hormonal Therapy:

4 Neoadjuvant Regimens AC x 4 Doc x 4 4 cycles of AC followed by 4 cycles of docetaxel 100 mg/m 2 every 3 weeks Docetaxel carboplatin with docetaxel 75 mg/m 2 IV day 1 every 3 weeks x 6 cycles carboplatin AUC = 6 8 mg/kg (LD) cycle 1; 6 mg/kg (MD) cycles 2-6 FEC x 4 Doc x 4 4 cycles of FEC followed by 4 cycles of docetaxel 100 mg/m 2 every 3 weeks If patients are HER2 positive and physician chooses either AC x 4 Doc x 4 or FEC x 4 Doc x 4, the would start with the first cycle of docetaxel at 8 mg/kg for cycle 1 of docetaxel and then 6 mg/kg for subsequent cycles of docetaxel. Paclitaxel-Carboplatin weekly with paclitaxel 80 mg/m 2 IV days 1, 8 & 15 every 4 weeks x 4-6 cycles carboplatin AUC = 2 IV days 1, 8 & 15 4 mg/kg (1 st dose); followed by 2 mg/kg weekly continuously Trastuzumab (maintenance) following chemotherapy, is to continue to a maximum of 1 year (equivalent of 18 doses given every 3 weeks) over a maximum of 14 months from the 1 st dose of.

5 Appendix: 4 Metastatic Regimens Abraxane nab-paclitaxel 260 mg/m 2 IV every 3 weeks AC doxorubin 60 mg/m 2 every 3 weeks x 4-6 cycles Cyclophosphamide 600 mg/m 2 Capecitabine 1000 mg/m 2 po bid x 14 days every 3 weeks CMF IV cyclophosphamide 600 mg/m 2 days 1 & 8 every 4 weeks methotrexate 40 mg/m 2 fluorouracil 600 mg/m 2 CMF oral cyclophosphamide 100 mg/m 2 po daily for 14 days every 4 weeks methotrexate 40 mg/m 2 days 1 & 8 fluorouracil 600 mg/m 2 days 1 & 8 Docetaxel Carboplatin with Trastuzumab docetaxel 75 mg/m 2 IV day 1 every 3 weeks carboplatin AUC = 6 IV day 1 Docetaxel Cyclophosphamide docetaxel 75 mg/m 2 IV day 1 every 3 weeks x 4 cycles cyclophosphamide 600 mg/m 2 IV day 1 Docetaxel Cyclophosphamide with Trastuzumab docetaxel 75 mg/m 2 IV day 1 every 3 weeks cyclophosphamide 600 mg/m 2 IV day 1

6 Docetaxel with docetaxel 100 mg/m 2 IV day 1 every 3 weeks Docetaxel 100 mg/m 2 IV day 1 every 3 weeks Docetaxel (weekly) 35 mg/m 2 IV days 1,8 &15 every 4 weeks Docetaxel weekly with docetaxel 35 mg/m 2 IV days 1,8 &15 every 4 weeks 4 mg/kg (1 st dose); followed by 2 mg/kg weekly continuously OR 8 mg/kg (1 st dose); followed by 6 mg/kg every 3 weeks Doxorubicin 60 mg/m 2 IV day 1 every 3 weeks FAC fluorouracil 500 mg/m 2 IV every 3 weeks doxorubicin 50 mg/m 2 IV cyclophosphamide 500 mg/m 2 IV FE 100C fluorouracil 500 mg/m 2 IV day 1 every 3 weeks epirubicin 100 mg/m 2 IV day 1 cyclophosphamide 500 mg/m 2 IV day 1 Gemcitabine 800 mg/m 2 IV weekly every 3 weeks out of 4 Lapatinib capecitabine lapatinib capecitabine 1,250 mg po daily continuously during chemotherapy, then 1,500 mg 1,000 mg/m 2 po bid x 14 days every 3 weeks Myocet (liposomal doxorubicin) 75mg/m 2 IV every 3 weeks Myocet-cyclophosphamide myocet 60 mg/m 2 IV every 3 weeks cyclophosphamide 600 mg/m 2 IV

7 Paclitaxel-gemcitabine paclitaxel 175 mg/m 2 IV every 3 weeks gemcitabine 1,250 mg/m 2 IV days 1&8 Paclitaxel 175 mg/m 2 IV every 3 weeks Paclitaxel (weekly ) 80 mg/m 2 IV weekly continuously Paclitaxel with paclitaxel 175 mg/m 2 IV every 3 weeks Paclitaxel weekly with paclitaxel 80 mg/m 2 IV 4 mg/kg (1 st dose); followed by 2 mg/kg weekly continuously OR 8 mg/kg (1 st dose), followed by 6 mg/kg every 3 weeks Trastuzumab weekly 4 mg/kg (1 st dose); followed by 2 mg/kg weekly continuously Trastuzumab every 3 weeks Vinorelbine 25 mg/m 2 IV days 1,8 & 15 every 4 weeks Vinorelbine with vinorelbine 25 mg/m 2 IV days 1,8 & 15 every 4 weeks 4 mg/kg (1 st dose); followed by 2 mg/kg weekly continuously

8 Hormonal Treatments Tamoxifen 20 mg po once daily Anastrozole 1 mg po once daily Letrozole 2.5 mg po once daily Exemestane 25 mg po once daily Fulvestrant 500 mg IM Day 1, 15 and 29 then 500 mg IM monthly

Regimens highlighted in red contain an expensive drug that is not currently publicly funded for the regimen and treatment intent.

Regimens highlighted in red contain an expensive drug that is not currently publicly funded for the regimen and treatment intent. Palliative Breast Cancer Regimens The following table lists the evidence-informed regimens (both IV and non-iv) for breast cancer used in the palliative setting. It is expected that the prescribing oncologist