Adjuvant/Curative/Neo-adjuvant Breast Cancer Regimens
The following table lists the evidence-informed regimens (both IV and non-IV) for breast cancer used in
the adjuvant/curative/neo-adjuvant setting. It is expected that the prescribing oncologist will select the
regimen from the list of evidence-informed regimens that is most appropriate for their patient taking
account of a variety of disease-specific and patient-related factors.
Regimens highlighted in red contain an expensive drug that is not currently publicly funded for the
regimen and treatment intent.
AC
Regimen Code
Breast Cancer
Regimen Abstract
DOXOrubicin 60 mg/m2 IV day 1;
Cyclophosphamide 600 mg/m2 IV day 1.
Q21 days
AC-DOCE
AC: (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q21 days
THEN
DOCEtaxel: (x 4 cycles):
DOCEtaxel 100 mg/m² IV day 1.
Q21 days
AC-DOCE+TRAS
AC: (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q21 days
THEN
DOCEtaxel: (x 4 cycles):
DOCEtaxel 100 mg/m² IV day 1.
Q21 days
For patients with HER2 positive tumours, Trastuzumab is given for one year starting
either concurrently with DOCEtaxel or after DOCEtaxel
Trastuzumab 8 mg/kg IV loading dose followed by 6 mg/kg IV.
Q21 days
Regimen Code
Breast Cancer
Regimen Abstract
AC-PACL
AC: (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q21 days
THEN
PACLitaxel (x 4 cycles):
PACLitaxel 175 mg/m² IV day 1.
Q21 days
AC-PACL(DD)
AC: (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q14 days
THEN
PACLitaxel (x 4 cycles):
PACLitaxel 175 mg/m² IV day 1.
Q14 days
AC-PACL(DD)+TRAS
AC: (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q14 days
THEN
PACLitaxel (x 4 cycles):
PACLitaxel 175 mg/m² IV day 1.
Q14 days
For patients with HER2 positive tumours, Trastuzumab is given for one year starting
either concurrently with PACLitaxel or after PACLitaxel
Trastuzumab 8 mg/kg IV loading dose followed by 6 mg/kg IV.
Q21 days
Alternative Trastuzumab schedule:
Trastuzumab 4 mg/kg IV loading dose followed by 2 mg/kg IV days 1, 8, 15, 22.
Q28 days
Regimen Code
AC-PACL(W)
Breast Cancer
Regimen Abstract
AC: (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q21 days
THEN
PACLitaxel Weekly (x 12 cycles):
PACLitaxel 80 mg/m² IV day 1.
Q7 days
Alternative chemotherapy schedule:
AC (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q14 days
THEN
PACLitaxel weekly (x 12 cycles)
PACLitaxel 80 mg/m² IV day 1.
Q7 days
AC-PACL(W)+TRAS
AC: (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q21 days
THEN
PACLitaxel Weekly (x 12 cycles)
PACLitaxel 80 mg/m² IV day 1.
Q7 days
For patients with HER2 positive tumours, Trastuzumab is given for one year starting
either concurrently with PACLitaxel or after PACLitaxel
Trastuzumab 8 mg/kg IV loading dose followed by 6 mg/kg IV.
Q21 days
Alternative chemotherapy schedule:
AC (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q14 days
THEN
PACLitaxel Weekly (x 12 cycles)
PACLitaxel 80 mg/m² IV day 1.
Q7 days
Alternative Trastuzumab schedule:
Trastuzumab 4 mg/kg IV loading dose followed by 2 mg/kg IV days 1, 8, 15, 22.
Q28 days
Regimen Code
Breast Cancer
Regimen Abstract
AC-PACL+TRAS
AC: (x 4 cycles):
DOXOrubicin 60 mg/m² IV day 1;
Cyclophosphamide 600 mg/m² IV day 1.
Q21 days
THEN
PACLitaxel (x 4 cycles):
PACLitaxel 175 mg/m² IV.
Q21 days
For patients with HER2 positive tumours, Trastuzumab is given for one year starting
either concurrently with PACLitaxel or after PACLitaxel
Trastuzumab 8 mg/kg IV loading dose followed by 6 mg/kg IV.
Q21 days
ANAS
Anastrozole 1 mg PO daily
CISPETOP(3D)
CISplatin 80-100 mg/m2 IV day 1;
Etoposide 100-120 mg/m2 IV days 1-3.
Q28 days
CISPETOP(5D)
CMF(PO)
Alternative Schedule:
CISplatin 60 mg/m2 IV day 1;
Etoposide 100-120 mg/m2 IV days 1-3.
Q21 days
For Small Cell Carcinoma
CISplatin 20 mg/m² IV days 1-5;
Etoposide 100 mg/m² IV days 1-5.
Q21 days
For Small Cell Carcinoma
Cyclophosphamide 100 mg/m² PO days 1-14;
Methotrexate 40 mg/m² IV day 1, 8;
Fluorouracil 600 mg/m² IV day 1, 8.
Q28 days
CMF(PO)+TRAS
Cyclophosphamide 100 mg/m² PO days 1-14;
Methotrexate 40 mg/m² IV day 1, 8;
Fluorouracil 600 mg/m² IV day 1, 8.
Q28 days
For patients with HER2 positive tumours, Trastuzumab is given for one year starting
either concurrently with or after completion of chemotherapy.
Trastuzumab 8 mg/kg IV loading dose followed by 6 mg/kg IV.
Q21 days
CRBPDOCETRAS
CARBOplatin AUC 5-6 IV day 1;
DOCEtaxel 75 mg/m² IV day 1.
Q21 days
For patients with HER2 positive tumours, Trastuzumab is given for one year starting
either concurrently with or after completion of chemotherapy.
Trastuzumab 8 mg/kg IV loading dose followed by 6 mg/kg IV.
Q21 days
Regimen Code
CRBPETOP(5D)
CYCLDOCE
CYCLDOCE+TRAS
CRBPETOP(5D)
DAC
EXEM
Breast Cancer
Regimen Abstract
CARBOplatin AUC 5 IV days 1;
Etoposide 100 mg/m² IV days 1-5.
Q21 days
For Small Cell Carcinoma
Cyclophosphamide 600 mg/m2 IV day 1;
DOCEtaxel 75 mg/m2 IV day 1.
Q21 days
Cyclophosphamide 600 mg/m² IV day 1;
DOCEtaxel 75 mg/m² IV day 1.
Q21 days
For patients with HER2 positive tumours, Trastuzumab is given for one year starting
either concurrently with or after completion of chemotherapy.
Trastuzumab 8 mg/kg IV loading dose followed by 6 mg/kg IV.
Q21 days
CARBOplatin AUC 5 IV day 1;
Etoposide 100 mg/m² IV days 1-5.
Q21 days
For Small Cell Carcinoma
DOXOrubucin 50 mg/m2 IV day 1
Cyclophosphamide 500 mg/m2 IV day 1
Docetaxel 75 mg/m2 IV day 1
Q21 days
Exemestane 25 mg PO daily
FEC100
Fluorouracil 500 mg/m² IV day 1;
EPIrubicin 100 mg/m² IV day 1;
Cyclophosphamide 500 mg/m² IV day 1.
Q21 days
FEC-D
FEC100 (x 3 cycles):
Fluorouracil 500 mg/m² IV day 1;
EPIrubicin 100 mg/m² IV day 1;
Cyclophosphamide 500 mg/m² IV day 1.
Q21 days
THEN
DOCEtaxel: (x 3 cycles)
DOCEtaxel 100 mg/m² IV day 1.
Q21 days
Regimen Code
Breast Cancer
Regimen Abstract
FEC-D+TRAS
FEC100 (x 3 cycles):
Fluorouracil 500 mg/m² IV day 1;
EPIrubicin 100 mg/m² IV day 1;
Cyclophosphamide 500 mg/m² IV day 1.
Q21 days
THEN
DOCEtaxel: (x 3 cycles)
DOCEtaxel 100 mg/m² IV day 1.
Q21 days
For patients with HER2 positive tumours, Trastuzumab is given for one year starting
either concurrently with DOCEtaxel or after DOCEtaxel
Trastuzumab 8 mg/kg IV loading dose followed by 6 mg/kg IV.
Q21 days
GOSE
Goserelin 3.6 mg SC.
Q28 days
LETR
Letrozole 2.5 mg PO daily
LPRL
Leuprolide 22.5 mg IM
Q3 months
PACL(W)+TRAS
PACLitaxel weekly (x 12 weeks):
PACLitaxel 80 mg/m2 IV day 1
Q7 days
PLUS trastuzumab to be given for one year, starting concurrently with PACLitaxel
Weekly Trastuzumab schedule:
Trastuzumab 4 mg/kg IV loading dose day 1 (week 1) THEN 2 mg/kg IV maintenance
dose day 1 (starting week 2)
Q7 days
OR
TMXF
TRAS
Alternative Trastuzumab schedule:
Trastuzumab 8 mg/kg IV loading dose day 1 (cycle 1) THEN 6 mg/kg IV maintenance
dose day 1 (starting cycle 2)
Q21 days
Tamoxifen 20 mg PO daily
Trastuzumab 8 mg/kg IV loading dose followed by 6 mg/kg IV
Q21 days
PDRP (NDFP) funding is contingent on the patient previously receiving
chemotherapy.
For treatment delays ≥ to 3 weeks (i.e. ≥ 6 weeks from last dose), consider reloading
with loading dose. Please refer to the day 1 loading dose outlined in PACL+TRAS.
Regimen Code
ZOLE
Breast Cancer
Regimen Abstract
Zoledronic acid 4 mg IV every 6 months for up to 3-5 years
Adjuvant zoledronic acid should be used in post-menopausal women only. This may
include women who are prescribed GnRH analogs for ovarian suppression. In this case,
zoledronic acid should be given for the same duration as the GnRH analog. Ideally,
treatment should be initiated within 12 weeks of completion of adjuvant chemo or
radiation. However, consideration should be given to the late initiation of adjuvant
zoledronic acid therapy to women who may have been eligible after December 2013,
when the results of the systematic review were first presented.
Last Updated: January 2017