NCCN Guidelines for Invasive Breast Cancer



HER2-POSITIVE DISEASE – DOSING SCHEDULE FOR COMBINATIONS
(Version 1.2014)

ADJUVANT – PREFERRED:

  1. AC followed by T (paclitaxel) chemotherapy with trastuzumab [4 cycles + 12 wks]
  2. AC followed by T (paclitaxel) chemotherapy with trastuzumab + pertuzumab [4 cycles + 4 cycles]
  3. Dose-dense AC – followed by T (paclitaxel) chemotherapy with trastuzumab [4 cycles + 4 cycles]
  4. TCH chemotherapy (docetaxel + carboplatin + trastuzumab) [4 cycles + 17 wks]
  5. TCH chemotherapy (docetaxel + carboplatin + trastuzumab +pertuzumab) [6 cycles]

ADJUVANT – OTHER:

  1. AC followed by docetaxel chemotherapy with trastuzumab [4 cycles + 4 cycles]
  2. AC followed by docetaxel chemotherapy with trastuzumab and pertuzumab [4 cycles + 4 cycles]
  3. FEC chemotherapy followed by pertuzumab + trastuzumab + docetaxel [6 cycles + 17 wks]
  4. FEC chemotherapy followed by pertuzumab + trastuzumab + paclitaxel [6 cycles]

NEOADJUVANT:

  1. pertuzumab + trastuzumab + docetaxel – followed by FEC chemotherapy [4 cycles + 3 cycles]
  2. pertuzumab + trastuzumab + paclitaxel – followed by FEC chemotherapy [4 cycles + 3 cycles]
Key: 
AC  = Doxorubicin + Cyclophosphamide
TCH = Docetaxel + Carboplatin + Trastuzumab
FEC = Fluorouracil + Epirubicin + Cyclophosphamide
T   = Paclitaxel 

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