Which trastuzumab regimens are used in the treatment of HER2/neu-positive breast cancer?

Updated: Apr 23, 2020
  • Author: Joseph A Sparano, MD; Chief Editor: John V Kiluk, MD, FACS  more...
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Answer

Answer

The following regimens have been shown to be more effective than non-trastuzumab regimens (with which they were compared):

  • AC-paclitaxel plus trastuzumab: Doxorubicin 60 mg/m2 IV plus  cyclophosphamide 600 mg/m2 IV on day 1 every 3 wk, followed by paclitaxel 80 mg/m2 IV weekly for 12 cycles or  175 mg/m2 IV every 3 wk for four cycles given concurrently with trastuzumab 4 mg/kg for the first dose and then 2 mg/kg weekly with each paclitaxel dose; followed by trastuzumab 6 mg/kg every 3 wk for 14 doses, for a 1-y total duration of trastuzumab therapy [14] or

  • AC-docetaxel plus trastuzumab: Doxorubicin 60 mg/m2 IV plus  cyclophosphamide 600 mg/m2 IV on day 1 every 3 wk for four cycles, followed by docetaxel 100 mg/m2 every 3 wk for four cycles given concurrently with trastuzumab 4 mg/kg IV during week 1 and then 2 mg/kg IV weekly for 11 wk; followed by trastuzumab 6 mg/kg every 3 wk to complete 1 y of trastuzumab [15] or

  • TCH: Docetaxel 75 mg/m2 plus carboplatin AUC 6 IV on day 1 every 3 wk for six cycles plus  trastuzumab 4 mg/kg during week 1 and then 2 mg/kg weekly for 17 wk; followed by trastuzumab 6 mg/kg every 3 wk to complete 1-y total duration of trastuzumab therapy; this regimen may be more appropriate for patients with contraindications to anthracycline therapy [15] (see the Carboplatin AUC Dose Calculation [Calvert formula] calculator)


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