Acceptable Adjuvant Chemotherapy Regimens for Patients with
Higher-Risk Early Breast Cancer
➤ These adjuvant chemotherapy regimens can be used for patients with early
breast cancer:
• Fluorouracil-epirubicin-cyclophosphamide × 3 → docetaxel × 3
(superior to fluorouracil-epirubicin-cyclophosphamide x 6)
• Doxorubicin-cyclophosphamide × 4 → docetaxel × 4
(superior to doxorubicin-cyclophosphamide × 4)
• Docetaxel-doxorubicin-cyclophosphamide × 6
(superior to fluorouracil-doxorubicin-cyclophosphamide × 6)
• Doxorubicin-cyclophosphamide × 4 → paclitaxel administered once per week
• Dose-dense doxorubicin-cyclophosphamide → paclitaxel administered once every
2 weeks
• Dose-dense epirubicin 90 mg/m
2
, cyclophosphamide 600 mg/m
2
every 2 weeks × 4 →
paclitaxel 175 mg/m
2
every 2 weeks × 4
Adjuvant Regimen When an Anthracycline Is Not Preferred
➤ Docetaxel-cyclophosphamide × 4 is recommended as an alternative to
doxorubicin-cyclophosphamide × 4 and offers improved disease-free survival
and overall survival. Classic cyclophosphamide-methotrexate-fluorouracil with
oral cyclophosphamide for six cycles is another option.
• As mentioned before, the ASCO Panel recommends classic cyclophosphamide-
methotrexate-fluorouracil (oral cyclophosphamide days 1–14 with IV methotrexate-
fluorouracil days 1 and 8, repeated once every 28 days for six cycles) as the default
adjuvant cyclophosphamide-methotrexate-fluorouracil regimen.
• However, the Panel also recognizes that an all-IV cyclophosphamide-methotrexate-
fluorouracil regimen once every 21 days is often used in clinical practice and was
accepted by some clinical trials (e.g., TAILORx) on the basis of its convenience and
tolerability despite the absence of efficacy data from randomized controlled trials.
Treatment
