BREAST CANCER - METASTATIC & LOCALLY ADVANCED CHEMOTHERAPY REGIMENS Capecitabine. Capecitabine + Docetaxel. Capecitabine + Vinorelbine
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1 Capecitabine Capecitabine mg/m 2 oral TWICE daily for 14 days Until disease progression Capecitabine + Docetaxel Capecitabine mg/m 2 oral TWICE daily for 14 days Up to 6 cycles Capecitabine + Vinorelbine Vinorelbine 60mg/ m 2 orally as a single dose Maximum dose 120mg. Capecitabine 1000mg/m 2 oral TWICE daily for 14 days Vinorelbine 60mg/ m 2 orally as a single dose Maximum dose 120mg. Until disease progression. Carboplatin +/- Gemcitabine : Gemcitabine 1250mg/m 2 IV infusion Carboplatin AUC 5 IV infusion : Gemcitabine 1250mg/m 2 IV infusion Cycle Frequency: Repeat every 21 days Up to 4 cycles Written By: C Ward Authorised By: EM Breast Oncologists Page Number1/6
2 Carboplatin +/- Vinorelbine : Carboplatin AUC 5 PLUS Vinorelbine 25mg/m 2 IV (max. 60mg) OR Vinorelbine 60mg/m 2 Oral (max. 160mg) : Vinorelbine 25mg/m 2 IV (max. 60mg) OR Vinorelbine 60mg/m 2 Oral (max. 160mg) Cycle Frequency: repeat every 21 days up to 4 cycles CMF IV Cyclophosphamide 600 mg/m 2 IV Fluorouracil 600 mg/m 2 IV Cyclophosphamide 600 mg/m 2 IV Fluorouracil 600 mg/m 2 IV Every 28 days Up to 6 cycles or relapse CMF Oral Cyclophosphamide 100 mg/m 2 orally for 14 days Fluorouracil 600 mg/m2 IV Fluorouracil 600 mg/m 2 IV Every 28 days Up to 6 cycles or relapse Written By: C Ward Authorised By: EM Breast Oncologists Page Number2/6
3 Docetaxel : Docetaxel mg/m 2 IV infusion Cycle Frequency: Repeat every 21 days Up to 6 cycles Docetaxel + Pertuzumab+ Trastuzumab Day 0 Trastuzumab 8mg/kg cycle 1 only IV infusion Pertuzumab 840mg cycle 1 only IV infusion Trastuzumab 6mg/kg cycle 2 onwards IV infusion Pertuzumab 420mg cycle 2 onwards IV infusion Up to 6 cycles docetaxel AND Pertuzumab & trastuzumab until progression outside the CNS. Docetaxel + Trastuzumab Intravenous Day 0 Trastuzumab 8mg/kg cycle 1 only IV infusion Trastuzumab 6mg/kg cycle 2 onwards IV infusion Up to 6 cycles docetaxel, trastuzumab until progression outside the CNS. Docetaxel + Trastuzumab Subcutaneous Trastuzumab 600mg subcutaneously Up to 6 cycles docetaxel, trastuzumab until progression outside the CNS. Written By: C Ward Authorised By: EM Breast Oncologists Page Number3/6
4 EC Epirubicin 75mg/m 2 IV Cyclophosphamide mg/m 2 IV Up to 4 cycles Eribulin : Eribulin base 1.23mg/m 2 IV infusion : Eribulin base 1.23mg/m 2 IV infusion Following at least two prior therapies for advanced disease. Cycle Frequency: Until disease progression FEC 75 : Fluorouracil 600mg/m 2 IV Epirubicin 75mg/m 2 IV Cyclophosphamide 600mg/m 2 IV Cycle Frequency: Up to 6 cycles FEC 100 : Fluorouracil 500mg/m 2 IV Epirubicin 100mg/m 2 IV Cyclophosphamide 500mg/m 2 IV Cycle Frequency: Up to 6 cycles Gemcitabine 5* Every 28 days or 21 days if omit day 15* Until disease progression Written By: C Ward Authorised By: EM Breast Oncologists Page Number4/6
5 Gemcitabine + Paclitaxel Paclitaxel 175mg/ m 2 IV infusion Up to 6 cycles MMM Mitomycin C 8mg/ m 2 or 10 mg IV bolus Methotrexate 35mg/ m 2 or 50 mg IV bolus Mitoxantrone 8mg/ m 2 or 10 mg IV bolus Day 22 Methotrexate 35mg/ m 2 or 50 mg IV bolus Mitoxantrone 8mg/ m 2 or 10 mg IV bolus Every 42 days Up to 6 cycles or relapse Paclitaxel Paclitaxel 80mg/ m 2 IV infusion Every 7 days Until disease progression Trastuzumab Intravenous Trastuzumab 8mg/kg cycle 1 only IV infusion then Trastuzumab 6mg/kg cycle 2 onwards IV infusion Until progression outside the CNS. Written By: C Ward Authorised By: EM Breast Oncologists Page Number5/6
6 Trastuzumab Subcutaneous Trastuzumab 600mg subcutaneously Until progression outside the CNS. Trastuzumab Emtansine (Kadcyla ) Trastuzumab Emtansine 3.6mg/kg IV infusion Until disease progression Vinorelbine ORAL *Vinorelbine 60mg/ m 2 orally as a single dose Maximum dose 120mg. *Consider increasing vinorelbine dose after the 3rd dose to 80mg/m 2 maximum 160mg Every 7 days or day 1 & 8 of 21 day cycle. Until disease progression Vinorelbine Intravenous Vinorelbine 25-30mg/ m 2 IV infusion as a single dose Maximum dose 60mg. Every 7 days or day 1 & 8 of 21 day cycle. Until disease progression Written By: C Ward Authorised By: EM Breast Oncologists Page Number6/6
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