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
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.
Adjuvant Hormonal Therapy:
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.
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
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
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
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