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What is Chemotherapy?

See Breast Cancer Treatment Information from the National Cancer Institute

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapeutic drugs travel through the bloodstream to destroy cancer cells throughout the body that have migrated from the breast tumor. Chemotherapy is given in an outpatient setting, either orally or intravenously and usually in cycles. Medical oncologists at Fox Chase may prescribe chemotherapy drugs alone or in combination with other drugs to get the best outcome for you.

New Test May Show Whether You Need Chemotherapy

Oncotype DX™ is available to select patients with early stage breast cancer. Results allow Fox Chase physicians to determine whether you need chemotherapy and if so, which combinations may be right for you. In addition, it predicts the chance of your breast cancer coming back.

Ongoing Clinical Research on Chemotherapy

Over the past 3 decades, researchers at the nation's leading cancer centers, including Fox Chase, have participated in clinical research studies to learn the most effective combinations of chemotherapy drugs for breast cancer. Physicians at Fox Chase continue to develop, lead and participate in national clinical trials to compare the current treatment to a new therapy or combination of therapies that may be more effective in treating cancer and/or have fewer side effects.

Chemotherapy Drugs

Different drugs are useful for different cancers. Research has shown that combinations of certain drugs are more effective than individual drugs. The following chemotherapy drugs may be used to treat breast cancer:

• Cyclophosphamide (Cytoxan or Neosar)
• Methotrexate
• Fluorouracil (5-FU)
• Doxorubicin (Adriamycin)
• TAC - docetaxel/doxorubicin/cyclophosphamide with or without filgrastim support
• ACMF - doxorubicin followed by cyclophosphamide/methotrexate/fluorouracil
• ACT - doxorubicin/cyclophosphamide followed by paclitaxel or docetaxel
• A-T-C - doxorubicin followed by paclitaxel followed by cyclophosphamide

Metastatic or Advanced Breast Cancer

For women whose cancer has spread or recurred (come back), the following chemotherapy agents may be used alone:

• Anthracyclines (doxorubicin or epirubicin)
• Cyclophosphamide (Cytoxan or Neosar)
• Methotrexate
• Fluorouracil (5-FU)
• Gemcitabine
• Doxorubicin (Adriamycin)
• Epirubicin (Ellence)
• Paclitaxel (Taxol)
• Docetaxel (Taxotere)
• Vinorelbine (Navelbine)
• Capecitabine (Xeloda)

Preferred Combination Chemotherapy Options for Metastatic or Advanced Breast Cancer

• CAF/FAC - fluorouracil/doxorubicin/cyclophosphamide
• CEF - cyclophosphamide/epirubicin/fluorouracil
• AC - doxorubicin/cyclophosphamide
• EC - epirubicin/cyclophosphamide
• AT - doxorubicin/docetaxel or doxorubicin/paclitaxel
• CMF - cyclophosphamide/methotrexate/fluorouracil
• Docetaxel/capecitabine
• GT - gemcitabine/paclitaxel

Other Active Drugs for Metastastic or Recurrent Cancer

• Platinum drugs (Cisplatin, Carboplatin)
• Etoposide pills
• Vinblastine
• Fluorouracil - as a continuous infusion

Preferred Chemotherapy Combinations with Trastuzumab for Metastatic or Recurrent Cancer

• Paclitaxel with or without carboplatin
• Docetaxel with or without carboplatin
• Vinorelbine

Chemotherapy is given in cycles with each period of treatment followed by a rest period of 2-3 weeks to allow the body to recover. These cycles generally last 3-6 months depending on the drugs used.

Side Effects of Chemotherapy for Breast Cancer

The side effects of chemotherapy depend on the type of drugs used, the amount taken and the length of treatment.

Many side effects can be treated with drugs that prevent or reduce nausea and vomiting. Growth factors are drugs that stimulate the production of red or white blood cells. They can help bone marrow recover after chemotherapy and prevent problems resulting from low blood counts. The use of these drugs allows doctors to give chemotherapy more frequently.

The supportive care team at Fox Chase Cancer Center helps patients manage the side effects of chemotherapy.

For more information about breast cancer treatment and prevention at Fox Chase Cancer Center or to make an appointment, call 1-888-FOX CHASE (1-888-369-2427). The breast cancer scheduling department can be reached at 215-728-3001.

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