Chemotherapy Drug Regimes


Written by : Dr.M.D.Mazumdar, MD

Different Regimens of Chemotherapy for Breast Cancer:

Chemotherapy drugs work by inhibiting the cancer cells from dividing and growing. Different drugs work at different stage sof the cell cyle (the process of division and growth of the cells).

Alkylating agents keep the cell from reproducing (making copies of itself) by damaging its DNA. These drugs work in all phases of the cell cycle.

Antimetabolites interfere with DNA and RNA of the cancer cells. This prevents the DNA from makeing copies of itself and thus preventing the cell from reproducing.

Anti-tumor antibiotics are chemotherapy drugs whihc interfere with enzymes involved in copying DNA during the cell cycle. This will then prevent the DNA from replicating and the cell from dividing into new cancer cells.

Mitotic inhibitors, also called plant alkaloids, are compounds derived from natural products, such as plants. They work by stopping cells from dividing to form new cells, but can damage cells in all phases by keeping enzymes from making proteins needed for cell reproduction.

These drugs, commonly used in the treatment of breast cancer, are usually given in combinations. A drug which acts on the cancer cells in a particular manner is combined with another drug which acts on them in a differnt manner. These combinations are known as regimens.

  • AC (or CA): Adriamycin (doxorubicin) and cyclophosphamide given 3-weekly for 4 cycles.

  • CMF :cyclophosphamide, methotrexate, and 5-fluorouracil given 4-weekly for 6 cycles.

  • FAC (or CAF): 5-fluorouracil, doxorubicin, cyclophosphamide given 3-weekly for 6 cycles.

  • AC-Taxol:AC given 3-weekly for 4 cycles followed by paclitaxel given either 3-weekly for 4 cycles or weekly (at a smaller dose) for 12 weeks.

  • TAC: Taxotere (docetaxel), Adriamycin (doxorubicin), and cyclophosphamide given 3-weekly for 6 cycles.

  • FEC: 5-fluorouracil, epirubicin and cyclophosphamide given 3-weekly for 6 cycles.

  • FECD: FEC given 3-weekly for 3 cycles followed by docetaxel given 3-weekly for 3 cycles.

  • TC: Taxotere (docetaxel) and cyclophosphamide given 3-weekly for 4 or 6 cycles.

  • GET: Gemzar, Ellence, and Taxol

  • Dose dense regimen: Some of the regimens above (e.g. AC followed by paclitaxel) may be given in a shorter period (i.e. every 2 weeks instead of every 3 weeks).

  • Trastuzumab: In addition to chemotherapy, trastuzumab may also be added to the regimen depending on the tumor characteristics (i.e. HER2/neu status) and risk of relapse. Also called Herceptin, it is usually given either 3 weekly or weekly for a total duration of 1 year.

Other Specific Drugs for Breast Cancer Chemotherapy:

  • Anthracyclines: These are chemically similar to antibiotics but work against cancer cells. They specifically target the genetic material of the cells. Some examples are Adriamycin, Ellence, and Daunorubicin.

  • Taxanes: They prevent the active division of cancer cells. Some examples are Taxol, Taxotere, and Abraxane.

Besides chemotherapy, certain drugs target the estrogen receptors in breast cells. Since some breast cancers are estrogen receptor positve, these drugs are effective against these type of breast cells. They constitute the hormonal therapy of breast cancer.

Common Chemotherapy Drugs used in Treatment of Breast Cancer:

  • Abraxane (chemical name: paclitaxel)
  • Taxotere (chemical name: docetaxel)
  • Taxol (chemical name: paclitaxel)
  • Adriamycin (chemical name: doxorubicin)
  • Doxil (chemical name: doxorubicin)
  • Cytoxan (chemical name: cyclophosphamide)
  • Daunorubicin (brand names: Cerubidine, DaunoXome)
  • Fluorouracil (also called 5-fluorouracil or 5-FU; brand name: Adrucil)
  • Gemzar (chemical name: gemcitabine)
  • Carboplatin (brand name: Paraplatin)
  • Thiotepa (brand name: Thioplex)
  • Vincristine (brand names: Oncovin, Vincasar PES, Vincrex)
  • Ellence (chemical name: epirubicin)
  • Ixempra (chemical name: ixabepilone)
  • Methotrexate (brand names: Amethopterin, Mexate, Folex)
  • Mitomycin (chemical name: mutamycin)
  • Mitoxantrone (brand name: Novantrone)
  • Navelbine (chemical name: vinorelbine)
  • Xeloda (chemical name: capecitabine)

Previous: Symptoms of Breast Cancer
Next: Types of Breast Cancer