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Chemotherapy > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

PREOPERATIVE/ADJUVANT THERAPY REGIMENS

Regimen for HER2- disease

A

Preferred regimens:

  • Dose-dense AC (doxorubicin/cyclophosphamide) followed by paclitaxel every 2 weeks
  • Dose dense AC (doxorubicin/cyclophosphamide) followed by weekly paclitaxel
  • TC (docetaxel and cyclophosphamide)

Other regimens:

  • Dose-dense AC (doxorubicin/cyclophosphamide) -AC (doxorubicin/cyclophosphamide) every 3 weeks (category 2B)
  • CMF (cyclophosphamide/methotrexate/fluorouracil)
  • AC followed by docetaxel every 3 weeks
  • AC followed by weekly paclitaxel
  • EC (epirubicin/cyclophosphamide)
  • FEC/CEF followed by T (fluorouracil/epirubicin/cyclophosphamide followed by docetaxel) or (fluorouracil/epirubicin/cyclophosphamide followed by weekly paclitaxel)
  • FAC followed by T (fluorouracil/doxorubicin/cyclophosphamide followed by weekly paclitaxel)
  • TAC (docetaxel/doxorubicin/cyclophosphamide
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2
Q

PREOPERATIVE/ADJUVANT THERAPY REGIMENS

Regimen for HER2+ disease

A

Preferred regimens:

  • AC followed by T + trastuzumab ± pertuzumab
  • TCH (docetaxel/carboplatin/trastuzumab) ± pertuzumab

Other regimens:

  • AC followed by docetaxel + trastuzumab ± pertuzumab
  • Docetaxel + cyclophosphamide + trastuzumab
  • FEC followed by docetaxel + trastuzumab + pertuzumab
  • FEC followed by paclitaxel + trastuzumab + pertuzumab
  • Paclitaxel + trastuzumab
  • Pertuzumab + trastuzumab + docetaxel followed by FEC
  • Pertuzumab + trastuzumab + paclitaxel followed by FEC
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3
Q

CHEMOTHERAPY REGIMENS FOR RECURRENT OR METASTATIC BREAST CANCER
Preferred single agents

A 
Anthracyclines 
• Doxorubicin 
• Pegylated liposomal doxorubicin Taxanes 
• Paclitaxel Anti-metabolites 
• Capecitabine 
• Gemcitabine Other microtubule inhibitors 
• Vinorelbine 
• Eribulin
Other single agents: 
• Cyclophosphamide 
• Carboplatin 
• Docetaxel 
• Albumin-bound paclitaxel 
• Cisplatin 
• Epirubicin 
• Ixabepilone
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4
Q

CHEMOTHERAPY REGIMENS FOR RECURRENT OR METASTATIC BREAST CANCER
Chemotherapy combinations

A
  • CAF/FAC (cyclophosphamide/doxorubicin/fluorouracil)
  • FEC (fluorouracil/epirubicin/cyclophosphamide)
  • AC (doxorubicin/cyclophosphamide)
  • EC (epirubicin/cyclophosphamide)
  • CMF (cyclophosphamide/methotrexate/fluorouracil)
  • Docetaxel/capecitabine
  • GT (gemcitabine/paclitaxel)
  • Gemcitabine/carboplatin
  • Paclitaxel/bevacizumab
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5
Q

CHEMOTHERAPY REGIMENS FOR RECURRENT OR METASTATIC BREAST CANCER
Preferred first-line agents for HER2 positive disease:

A
  • Pertuzumab + trastuzumab + docetaxel (category 1)

* Pertuzumab + trastuzumab + paclitaxel

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6
Q

CHEMOTHERAPY REGIMENS FOR RECURRENT OR METASTATIC BREAST CANCER
Other agents for HER2 positive disease:

A
  • Ado-trastuzumab emtansine (T-DM1)
  • Trastuzumab + paclitaxel ± carboplatin
  • Trastuzumab + docetaxel
  • Trastuzumab + vinorelbine
  • Trastuzumab + capecitabine
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7
Q

CHEMOTHERAPY REGIMENS FOR RECURRENT OR METASTATIC BREAST CANCER
Agents for trastuzumab-exposed HER2 positive disease:

A
  • Lapatinib + capecitabine
  • Trastuzumab + capecitabine
  • Trastuzumab + lapatinib (without cytotoxic therapy)
  • Trastuzumab + other agents
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8
Q

LHRG agonist

A

Goserelin

Leuprolide

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9
Q

Selective aromatase inhibitors

A

Anastrozole
Letrozole
Exemestane

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10
Q

SSRIs

A

Fluoxetine

Paroxetine

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11
Q

Dose-dense AC chemotherapy

HER2- other regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 14 days for 4 cycles
(All cycles are with myeloid growth factor support)

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12
Q

AC chemotherapy

HER2- other regimen

A

Doxorubicin 60 mg/m2 IV on day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles

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13
Q

TAC chemotherapy

HER2- other regimen

A

Docetaxel 75 mg/m2 IV day 1
Doxorubicin 50 mg/m2 IV day 1 Cyclophosphamide 500 mg/m2 IV day 1
Cycled every 21 days for 6 cycles
(All cycles are with myeloid growth factor support)

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14
Q

CMF chemotherapy

HER2- other regimen

A

Cyclophosphamide 100 mg/m2 PO days 1–14
Methotrexate 40 mg/m2 IV days 1 & 8
5-fluorouracil 600 mg/m2 IV days 1 & 8
Cycled every 28 days for 6 cycles

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15
Q

AC followed by docetaxel chemotherapy

HER2- other regimen

A

Doxorubicin 60 mg/m2 IV on day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.

Followed by:
Docetaxel 100 mg/m2 IV on day 1
Cycled every 21 days for 4 cycles.

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16
Q

AC followed by weekly paclitaxel

HER2- other regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.

Followed by:
Paclitaxel 80 mg/m2 by 1 h IV infusion weekly for 12 wks

17
Q

EC chemotherapy

HER2- other regimen

A

Epirubicin 100 mg/m2 IV day 1 Cyclophosphamide 830 mg/m2 IV day 1 Cycled every 21 days for 8 cycles

18
Q

Dose-dense AC followed by paclitaxel chemotherapy

HER2- Preferred regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 14 days for 4 cycles.
(All cycles are with myeloid growth factor support)

Followed by:
Paclitaxel 175 mg/m2 by 3 h IV infusion day 1 Cycled every 14 days for 4 cycles.
(All cycles are with myeloid growth factor support)

19
Q

Dose-dense AC followed by weekly paclitaxel chemotherapy

HER2- Preferred regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 14 days for 4 cycles.
(All cycles are with myeloid growth factor support)

Followed by:
Paclitaxel 80 mg/m2 by 1 h IV infusion weekly for 12 wks.

20
Q

TC chemotherapy

HER2- Preferred regimen

A

Docetaxel 75 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.
(All cycles are with myeloid growth factor support)

21
Q

AC followed by T chemotherapy with trastuzumab

HER2+ Preferred regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.

Followed by:
Paclitaxel 80 mg/m2 by 1 h IV weekly for 12 wks With:
Trastuzumab 4 mg/kg IV with first dose of paclitaxel
Followed by: • Trastuzumab 2 mg/kg IV weekly to complete 1 y of treatment.

As an alternative,
trastuzumab 6 mg/kg IV every 21 days may be used following the completion of paclitaxel, and given to complete 1 y of trastuzumab treatment. Evaluate left ventricular ejection fraction (LVEF) prior to and during treatment

22
Q

AC followed by T chemotherapy with trastuzumab + pertuzumab

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.

Followed by:
Pertuzumab 840 mg IV day 1 followed by 420 mg IV Trastuzumab 8 mg/kg IV day 1 followed by 6 mg/kg IV Paclitaxel 80 mg/m2 IV days 1, 8, and 15
Cycled every 21 days for 4 cycles
Trastuzumab 6 mg/kg IV day 1 Cycled every 21 days to complete 1 y of trastuzumab therapy Evaluate LVEF prior to and during treatment.*

23
Q

LHRG agonist

A

Goserelin

Leuprolide

24
Q

Selective aromatase inhibitors

A

Anastrozole
Letrozole
Exemestane

25
Q

SSRIs

A

Fluoxetine

Paroxetine

26
Q

Dose-dense AC chemotherapy

HER2- other regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 14 days for 4 cycles
(All cycles are with myeloid growth factor support)

27
Q

AC chemotherapy

HER2- other regimen

A

Doxorubicin 60 mg/m2 IV on day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles

28
Q

TAC chemotherapy

HER2- other regimen

A

Docetaxel 75 mg/m2 IV day 1
Doxorubicin 50 mg/m2 IV day 1 Cyclophosphamide 500 mg/m2 IV day 1
Cycled every 21 days for 6 cycles
(All cycles are with myeloid growth factor support)

29
Q

CMF chemotherapy

HER2- other regimen

A

Cyclophosphamide 100 mg/m2 PO days 1–14
Methotrexate 40 mg/m2 IV days 1 & 8
5-fluorouracil 600 mg/m2 IV days 1 & 8
Cycled every 28 days for 6 cycles

30
Q

AC followed by docetaxel chemotherapy

HER2- other regimen

A

Doxorubicin 60 mg/m2 IV on day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.

Followed by:
Docetaxel 100 mg/m2 IV on day 1
Cycled every 21 days for 4 cycles.

31
Q

AC followed by weekly paclitaxel

HER2- other regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.

Followed by:
Paclitaxel 80 mg/m2 by 1 h IV infusion weekly for 12 wks

32
Q

EC chemotherapy

HER2- other regimen

A

Epirubicin 100 mg/m2 IV day 1 Cyclophosphamide 830 mg/m2 IV day 1 Cycled every 21 days for 8 cycles

33
Q

Dose-dense AC followed by paclitaxel chemotherapy

HER2- Preferred regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 14 days for 4 cycles.
(All cycles are with myeloid growth factor support)

Followed by:
Paclitaxel 175 mg/m2 by 3 h IV infusion day 1 Cycled every 14 days for 4 cycles.
(All cycles are with myeloid growth factor support)

34
Q

Dose-dense AC followed by weekly paclitaxel chemotherapy

HER2- Preferred regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 14 days for 4 cycles.
(All cycles are with myeloid growth factor support)

Followed by:
Paclitaxel 80 mg/m2 by 1 h IV infusion weekly for 12 wks.

35
Q

TC chemotherapy

HER2- Preferred regimen

A

Docetaxel 75 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.
(All cycles are with myeloid growth factor support)

36
Q

AC followed by T chemotherapy with trastuzumab

HER2+ Preferred regimen

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.

Followed by:
Paclitaxel 80 mg/m2 by 1 h IV weekly for 12 wks With:
Trastuzumab 4 mg/kg IV with first dose of paclitaxel
Followed by: • Trastuzumab 2 mg/kg IV weekly to complete 1 y of treatment.

As an alternative,
trastuzumab 6 mg/kg IV every 21 days may be used following the completion of paclitaxel, and given to complete 1 y of trastuzumab treatment. Evaluate left ventricular ejection fraction (LVEF) prior to and during treatment

37
Q

AC followed by T chemotherapy with trastuzumab + pertuzumab

A

Doxorubicin 60 mg/m2 IV day 1 Cyclophosphamide 600 mg/m2 IV day 1 Cycled every 21 days for 4 cycles.

Followed by:
Pertuzumab 840 mg IV day 1 followed by 420 mg IV Trastuzumab 8 mg/kg IV day 1 followed by 6 mg/kg IV Paclitaxel 80 mg/m2 IV days 1, 8, and 15
Cycled every 21 days for 4 cycles
Trastuzumab 6 mg/kg IV day 1 Cycled every 21 days to complete 1 y of trastuzumab therapy Evaluate LVEF prior to and during treatment.*

Chemotherapy (23 decks)

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