ACTH: Doxorubicin and Cyclophosphamide, Followed by Paclitaxel and Trastuzumab

Updated 
August 31, 2015

ACTH is a chemotherapyinfo-icon combination treatment used to treat HER2-positive breast cancer. It may also be called sequential AC/Taxolinfo-icon-Trastuzumabinfo-icon.

The medicines in this combination are:

Trastuzumab is a type of targeted therapy called a monoclonal antibodyinfo-icon. It attaches to HER2 (human epidermal growth factor receptor 2info-icon) proteins and can kill HER2-positive cancer cells. 

How ACTH Works

Both doxorubicininfo-icon and cyclophosphamideinfo-icon (AC) damage the DNA inside cancer cells so they can’t divide, which causes them to die. With doxorubicin, the damage stops the cancer cells from dividing and causes them to die. Cyclophosphamide stops cancer cells from reproducing. 

Paclitaxelinfo-icon (T) is added to doxorubicin and cyclophosphamide (AC). It stops cancer cells from dividing into new cells.

Trastuzumabinfo-icon (H) attaches to HER2 proteins on the surface of HER2-positive cancer cells, and blocks the signals that cause the cancer cells to multiply.

Who Gets ACTH

ACTH is often used as adjuvant therapyinfo-icon, after surgeryinfo-icon, or as neoadjuvant therapyinfo-icon, before surgery, for early-stageinfo-icon breast cancers that are

  • HER2-positive and have traveled to the lymphinfo-icon nodes
  • HER2-positive and have not traveled to the lymph nodes (high-risk lymph nodeinfo-icon negative)

You and your doctor will discuss the best chemotherapyinfo-icon treatment for your situation.

How ACTH Is Given

AC is usually given

  • every 2-3 weeks for four cycles followed by
  • T every 2-3 weeks for four cycles, plus weekly H

Then H is given alone weekly or every 3 weeks over a year to complete treatment.

Side Effects and Things to Remember

Different medicines have different side effects. You may not have every side effectinfo-icon related to each medicineinfo-icon of the combination therapyinfo-icon. Side effects of ACTH may include:

Before starting ACTH, tell your doctor about any medicines you are taking, including vitamins, herbal supplements and over-the-counterinfo-icon medicines, to make sure they won’t interfere with your chemotherapyinfo-icon treatment.

Trastuzumabinfo-icon can cause complications in pregnancy, so you should not become pregnant while taking it.

Be sure to talk to your doctor, pharmacistinfo-icon or nurseinfo-icon about all your side effects so that they can help you manage them. You can also go to our section on Side Effects for more information.

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