AC-T: Doxorubicin and Cyclophosphamide, Followed by Paclitaxel or Docetaxel
- Doxorubicin (Adriamycin) - a type of chemotherapy medicine called an anthracycline
- Cyclophosphamide (Cytoxan) - a type of chemotherapy medicine called an alkylating agent
- Paclitaxel (Taxol) – a type of chemotherapy medicine called a taxane
Doxorubicin damages the DNA inside the cancer cells. The damage stops the cells from dividing, which causes them to die.
Cyclophosphamide attaches to and damages the DNA in cancer cells when they are in their resting phase (not dividing). After their DNA is damaged, the cells can’t keep dividing, and their growth slows or stops.
Paclitaxel works by damaging the structure or the “skeleton” that supports cancer cells. This stops the cancer cells from growing and dividing. Docetaxol (taxotere) works in a similar way and is sometimes used instead of paclitaxel.
AC-T is a standard regimen for breast cancers that require treatment with chemotherapy. Women with cancer of a higher grade and younger women often get this combination. It can also be used in people who have had a recurrence depending the medicines you received for early-stage disease.
AC-T can be given after surgery as adjuvant therapy, or before surgery as neoadjuvant therapy. Sometimes the AC portion is given before surgery and the taxane after, based on the cancer that remains in the breast after surgery.
You and your doctor will discuss the best chemotherapy treatment for your situation.
AC-T is usually given in eight treatments, once every 3 weeks. The first four treatments are AC, and the next four are paclitaxel (T). Sometimes the paclitaxel is given weekly at a lower dose instead of every 3 weeks. The whole course of AC-T treatment takes about 5 months.
AC-T is more commonly given on a dose-dense schedule of AC every 2 weeks for a total of four cycles, followed by T every 2 weeks for a total of four cycles.
Both AC and T are given by vein into your hand or arm.
Sometimes docetaxel is used instead of paclitaxel. The AC portion is given once every three weeks followed by docetaxel, which is also given once every three weeks.
Side effects of AC-T may include:
- Low red and white blood cell counts
- Nausea and vomiting
- Loss of appetite
- Hair loss
- Mouth sores
- Nail and skin changes
- Bladder irritation
- Bone pain
- Increased risk of sunburn
- Menopausal symptoms
- Heart damage
- Bruising or bleeding
Your doctor will check your blood before you start treatment. If your blood count is low then your treatment may be delayed.
Be sure to tell your doctor about any medicines you are taking, including vitamins, herbal supplements and over-the counter-medicines, to make sure they will not interfere with your chemotherapy treatment.
Drinking a lot of fluids can help avoid kidney and bladder side effects. Ask your doctor how much and how often you should drink each day. You should also avoid getting too much sun. When you go outside, wear sunscreen and clothes that cover your skin. Contact your doctor right away if you develop a fever or other symptoms of an infection such as a sore throat, cough or diarrhea.