ACTH: Doxorubicin and Cyclophosphamide, Followed by Paclitaxel and Trastuzumab
The medicines in this combination are:
- Doxorubicin (A; Adriamycin), an anthracycline, and cyclophosphamide (Cytoxan), an alkylating agent, followed by treatment with
- Paclitaxel (Taxol), a taxane chemotherapy, and trastuzumab (Herceptin)
Both doxorubicin and cyclophosphamide (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.
Paclitaxel (T) is added to doxorubicin and cyclophosphamide (AC). It stops cancer cells from dividing into new cells.
Trastuzumab (H) attaches to HER2 proteins on the surface of HER2-positive cancer cells, and blocks the signals that cause the cancer cells to multiply.
- HER2-positive and have traveled to the lymph nodes
- HER2-positive and have not traveled to the lymph nodes (high-risk lymph node negative)
You and your doctor will discuss the best chemotherapy treatment for your situation.
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.
- Low red and white blood cell counts
- Increased risk of bleeding
- Menopausal symptoms
- Nausea and vomiting
- Hair loss
- Risk of infection
- Mouth sores
- Joint pain
- Nail and skin changes
- Neuropathy, numbness and tingling in the hands and feet
- Heart damage
- Higher risk of leukemia
Before starting ACTH, tell your doctor about any medicines you are taking, including vitamins, herbal supplements and over-the-counter medicines, to make sure they won’t interfere with your chemotherapy treatment.
Trastuzumab can cause complications in pregnancy, so you should not become pregnant while taking it.