Difference between revisions of "Breast cancer"
Jump to navigation
Jump to search
| Line 12: | Line 12: | ||
*[[Dexamethasone]] 8 mg PO every 12 hours x 6 total doses, starting the day before treatment | *[[Dexamethasone]] 8 mg PO every 12 hours x 6 total doses, starting the day before treatment | ||
*Ciprofloxacin 500 mg PO BID on days 5-14 of every cycle (prophylaxis) | *Ciprofloxacin 500 mg PO BID on days 5-14 of every cycle (prophylaxis) | ||
| − | *G-CSF not originally routinely administered unless patients had febrile neutropenia, but NCCN recommends routine | + | *G-CSF not originally routinely administered unless patients had febrile neutropenia, but NCCN currently recommends routine filgrastim support: |
:*[[Filgrastim (Neupogen)]] 5 mcg/kg SC on days 4-11 | :*[[Filgrastim (Neupogen)]] 5 mcg/kg SC on days 4-11 | ||
:*Lenograstim 150 mcg/m2 on days 4-11 | :*Lenograstim 150 mcg/m2 on days 4-11 | ||
| Line 20: | Line 20: | ||
====References==== | ====References==== | ||
# Martin M, Pienkowski T, Mackey J, Pawlicki M, Guastalla JP, Weaver C, Tomiak E, Al-Tweigeri T, Chap L, Juhos E, Guevin R, Howell A, Fornander T, Hainsworth J, Coleman R, Vinholes J, Modiano M, Pinter T, Tang SC, Colwell B, Prady C, Provencher L, Walde D, Rodriguez-Lescure A, Hugh J, Loret C, Rupin M, Blitz S, Jacobs P, Murawsky M, Riva A, Vogel C; Breast Cancer International Research Group 001 Investigators. Adjuvant docetaxel for node-positive breast cancer. N Engl J Med. 2005 Jun 2;352(22):2302-13. [http://www.nejm.org/doi/full/10.1056/NEJMoa043681 link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/15930421 PubMed] | # Martin M, Pienkowski T, Mackey J, Pawlicki M, Guastalla JP, Weaver C, Tomiak E, Al-Tweigeri T, Chap L, Juhos E, Guevin R, Howell A, Fornander T, Hainsworth J, Coleman R, Vinholes J, Modiano M, Pinter T, Tang SC, Colwell B, Prady C, Provencher L, Walde D, Rodriguez-Lescure A, Hugh J, Loret C, Rupin M, Blitz S, Jacobs P, Murawsky M, Riva A, Vogel C; Breast Cancer International Research Group 001 Investigators. Adjuvant docetaxel for node-positive breast cancer. N Engl J Med. 2005 Jun 2;352(22):2302-13. [http://www.nejm.org/doi/full/10.1056/NEJMoa043681 link to original article] '''(contains protocol)''' [http://www.ncbi.nlm.nih.gov/pubmed/15930421 PubMed] | ||
| + | |||
| + | ===Dose-dense AC -> Paclitaxel (Taxol)=== | ||
| + | ====Regimen==== | ||
| + | '''All cycles given with [[Filgrastim (Neupogen)]] support''' | ||
| + | *[[Doxorubicin (Adriamycin)]] 60 mg/m2 IV day 1 | ||
| + | *[[Cyclophosphamide (Cytoxan)]] 600 mg/m2 IV day 1 | ||
| + | |||
| + | '''14-day cycles x 4 cycles, THEN''' | ||
| + | |||
| + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours day 1 | ||
| + | |||
| + | '''14-day cycles x 4 cycles''' | ||
| + | |||
| + | ====References==== | ||
| + | |||
| + | |||
| + | ===AC -> Paclitaxel (Taxol)=== | ||
| + | ====Regimen==== | ||
| + | *[[Doxorubicin (Adriamycin)]] 60 mg/m2 IV day 1 | ||
| + | *[[Cyclophosphamide (Cytoxan)]] 600 mg/m2 IV day 1 | ||
| + | |||
| + | '''21-day cycles x 4 cycles, THEN''' | ||
| + | |||
| + | *[[Paclitaxel (Taxol)]] 80 mg/m2 IV over 1 hour day 1 | ||
| + | |||
| + | '''1-week cycles x 12 cycles/weeks''' | ||
| + | |||
| + | ====References==== | ||
| + | |||
| + | ===TC=== | ||
| + | TC: '''<u>T</u>'''axotere, '''<u>C</u>'''ytoxan | ||
| + | |||
| + | ====Regimen==== | ||
| + | '''All cycles given with [[Filgrastim (Neupogen)]] support''' | ||
| + | *[[Docetaxel (Taxotere)]] 75 mg/m2 IV day 1 | ||
| + | *[[Cyclophosphamide (Cytoxan)]] 600 mg/m2 IV day 1 | ||
| + | |||
| + | '''21-day cycles x 4 cycles''' | ||
| + | |||
| + | ====References==== | ||
===FAC #1=== | ===FAC #1=== | ||
Revision as of 04:15, 19 February 2012
Adjuvant Therapy
TAC
TAC: Taxotere, Adriamycin, Cytoxan
Regimen
- Docetaxel (Taxotere) 75 mg/m2 IV over 1 hour on day 1 (administered third, one hour after cyclophosphamide)
- Doxorubicin (Adriamycin) 50 mg/m2 IV over 15 minutes on day 1 (administered first)
- Cyclophosphamide (Cytoxan) 500 mg/m2 IV over 1-5 minutes on day 1 (administered second)
- Dexamethasone 8 mg PO every 12 hours x 6 total doses, starting the day before treatment
- Ciprofloxacin 500 mg PO BID on days 5-14 of every cycle (prophylaxis)
- G-CSF not originally routinely administered unless patients had febrile neutropenia, but NCCN currently recommends routine filgrastim support:
- Filgrastim (Neupogen) 5 mcg/kg SC on days 4-11
- Lenograstim 150 mcg/m2 on days 4-11
21-day cycles x 6 cycles
References
- Martin M, Pienkowski T, Mackey J, Pawlicki M, Guastalla JP, Weaver C, Tomiak E, Al-Tweigeri T, Chap L, Juhos E, Guevin R, Howell A, Fornander T, Hainsworth J, Coleman R, Vinholes J, Modiano M, Pinter T, Tang SC, Colwell B, Prady C, Provencher L, Walde D, Rodriguez-Lescure A, Hugh J, Loret C, Rupin M, Blitz S, Jacobs P, Murawsky M, Riva A, Vogel C; Breast Cancer International Research Group 001 Investigators. Adjuvant docetaxel for node-positive breast cancer. N Engl J Med. 2005 Jun 2;352(22):2302-13. link to original article (contains protocol) PubMed
Dose-dense AC -> Paclitaxel (Taxol)
Regimen
All cycles given with Filgrastim (Neupogen) support
- Doxorubicin (Adriamycin) 60 mg/m2 IV day 1
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV day 1
14-day cycles x 4 cycles, THEN
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours day 1
14-day cycles x 4 cycles
References
AC -> Paclitaxel (Taxol)
Regimen
- Doxorubicin (Adriamycin) 60 mg/m2 IV day 1
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV day 1
21-day cycles x 4 cycles, THEN
- Paclitaxel (Taxol) 80 mg/m2 IV over 1 hour day 1
1-week cycles x 12 cycles/weeks
References
TC
TC: Taxotere, Cytoxan
Regimen
All cycles given with Filgrastim (Neupogen) support
- Docetaxel (Taxotere) 75 mg/m2 IV day 1
- Cyclophosphamide (Cytoxan) 600 mg/m2 IV day 1
21-day cycles x 4 cycles
References
FAC #1
FAC: Five-FU, Adriamycin, Cytoxan
Regimen
- Fluorouracil (5-FU) 500 mg/m2 IV over 15 minutes on day 1 (administered second)
- Doxorubicin (Adriamycin) 50 mg/m2 IV over 15 minutes on day 1 (administered first)
- Cyclophosphamide (Cytoxan) 500 mg/m2 IV over 1-5 minutes on day 1 (administered third)
- If patients had febrile neutropenia or infection: Ciprofloxacin 500 mg PO BID on days 5-14 of every cycle (prophylaxis)
- G-CSF not originally routinely administered unless patients had febrile neutropenia:
- Filgrastim (Neupogen) 5 mcg/kg SC on days 4-11
- Lenograstim 150 mcg/m2 on days 4-11
21-day cycles x 6 cycles
References
- Martin M, Pienkowski T, Mackey J, Pawlicki M, Guastalla JP, Weaver C, Tomiak E, Al-Tweigeri T, Chap L, Juhos E, Guevin R, Howell A, Fornander T, Hainsworth J, Coleman R, Vinholes J, Modiano M, Pinter T, Tang SC, Colwell B, Prady C, Provencher L, Walde D, Rodriguez-Lescure A, Hugh J, Loret C, Rupin M, Blitz S, Jacobs P, Murawsky M, Riva A, Vogel C; Breast Cancer International Research Group 001 Investigators. Adjuvant docetaxel for node-positive breast cancer. N Engl J Med. 2005 Jun 2;352(22):2302-13. link to original article (contains protocol) PubMed
Metastatic Disease
Eribulin (Halaven)
Regimen
- Eribulin (Halaven) 1.4 mg/m2 IV over 2 to 5 minutes on days 1 and 8
21-day cycles
References
- Cortes J, O'Shaughnessy J, Loesch D, Blum JL, Vahdat LT, Petrakova K, Chollet P, Manikas A, Diéras V, Delozier T, Vladimirov V, Cardoso F, Koh H, Bougnoux P, Dutcus CE, Seegobin S, Mir D, Meneses N, Wanders J, Twelves C; EMBRACE (Eisai Metastatic Breast Cancer Study Assessing Physician's Choice Versus E7389) investigators. Eribulin monotherapy versus treatment of physician's choice in patients with metastatic breast cancer (EMBRACE): a phase 3 open-label randomised study. Lancet. 2011 Mar 12;377(9769):914-23. link to original article (contains protocol) PubMed
Ixabepilone (Ixempra)
Regimen
- Ixabepilone (Ixempra) 40 mg/m2 IV on day 1
- Capecitabine (Xeloda) 2,000 mg/m2 orally on days 1 through 14
21-day cycles
References
- Sparano JA, Vrdoljak E, Rixe O, Xu B, Manikhas A, Medina C, Da Costa SC, Ro J, Rubio G, Rondinon M, Perez Manga G, Peck R, Poulart V, Conte P. Randomized phase III trial of ixabepilone plus capecitabine versus capecitabine in patients with metastatic breast cancer previously treated with an anthracycline and a taxane. J Clin Oncol. 2010 Jul 10;28(20):3256-63.link to original article (contains protocol) PubMed
- Thomas ES, Gomez HL, Li RK, Chung HC, Fein LE, Chan VF, Jassem J, Pivot XB, Klimovsky JV, de Mendoza FH, Xu B, Campone M, Lerzo GL, Peck RA, Mukhopadhyay P, Vahdat LT, Roché HH. Ixabepilone plus capecitabine for metastatic breast cancer progressing after anthracycline and taxane treatment. J Clin Oncol. 2007 Nov 20;25(33):5210-7. [1] (contains protocol) PubMed