What are the first-generation regimens for the treatment of stage I, IIA, IIB, or IIIA (T3N1M0) HER2/neu-negative breast cancer?

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

First-generation regimens

First-generation regimens are considered less effective than second- or third-generation regimens but do play a role in selected situations; CMF represents a reasonable alternative for patients who have contraindications to anthracycline (cardiac disease) and/or taxane therapy; AC would be a reasonable consideration for patients with contraindications to taxane therapy (eg, neuropathy). The regimens are as follows:

  • CMF: Cyclophosphamide 100 mg/m2 PO on days 1-14 plus  methotrexate 40 mg/m2 IV on days 1 and 8 plus  5-fluorouracil (5-FU) 600 mg/m2 IV on days 1 and 8 every 4 wk for six cycles [16] or

  • AC: Doxorubicin (Adriamycin) 60 mg/m2 IV plus  cyclophosphamide 600 mg/m2 IV on day 1 every 3 wk for four cycles (comparable to CMF) [10] or

  • CMF (PO): Cyclophosphamide 100 mg/m2 PO on days 1-14 plus  methotrexate 40 mg/m2 IV on days 1 and 8 plus  5-FU 600 mg/m2 IV on days 1 and 8 every 4 wk for six cycles or

  • CMF (IV): Cyclophosphamide 600 mg/m2 IV plus  methotrexate 40 mg/m2 IV plus  5-FU 600 mg/m2 IV on day 1 every 3 wk for eight cycles


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