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trastuzumab + doxorubicin + paclitaxel + cyclophosphamide + methotrexate + fluorouracil

Development stage
Phase 3
Lead developer
Roche
Modality
Monoclonal Antibodies → Antibody-Based Therapeutics, Small Molecules
Administration
Intravenous, Oral (cyclophosphamide And Methotrexate May Sometimes Be Given Orally, Though Iv Is Preferred In Combination Regimens)
01

Overview

This is a **multi-agent combination regimen** comprising trastuzumab (monoclonal antibody), doxorubicin (anthracycline), paclitaxel (taxane), cyclophosphamide (alkylating agent), methotrexate (antimetabolite), and fluorouracil (antimetabolite)[2][3][1]. - **Trastuzumab** targets the HER2 (human epidermal growth factor receptor 2) protein, blocking growth signals in HER2+ cancer cells[2][1]. - **Doxorubicin** inhibits topoisomerase II and intercalates DNA, preventing replication and transcription[2]. - **Paclitaxel** stabilizes microtubules, blocking cell division[2]. - **Cyclophosphamide** alkylates DNA, leading to cell death in rapidly dividing cells[2][3]. - **Methotrexate** inhibits dihydrofolate reductase, blocking DNA synthesis[3]. - **Fluorouracil** inhibits thymidylate synthase, disrupting DNA/RNA synthesis[3]. This combination is primarily used for the **adjuvant and neoadjuvant treatment of early-stage, high-risk, HER2-positive breast cancer**, especially post-surgery or pre-surgery settings[1][2][3]. No unique branded combination product of all six agents exists; the combination is based on protocolized regimens which sequence AC (doxorubicin + cyclophosphamide), CMF (cyclophosphamide + methotrexate + fluorouracil), trastuzumab, and paclitaxel as part of a multi-phase breast cancer chemotherapy approach[1][2][3].

Brand names
Herceptin (trastuzumab)Adriamycin (doxorubicin)Taxol (paclitaxel)Cytoxan (cyclophosphamide)Mexate (methotrexate)Folex (methotrexate)Rheumatrex (methotrexate)Amethopterin (methotrexate)5-FU (fluorouracil)
Other names
AC + T + H + CMF (referencing the combination of adjuvant chemotherapies and monoclonal antibody therapy commonly used in breast cancer treatment)ACTH + CMF (using common regimen naming conventions, not brand names)Sequential trastuzumab, doxorubicin, paclitaxel, cyclophosphamide, methotrexate, fluorouracil
02

Targets

DNADHFR (Dihydrofolate reductase)ERBB2 (Erb-b2 receptor tyrosine kinase 2)TS (Thymidylate synthase)TOP2A (DNA topoisomerase II)TUBB (Tubulin (alpha and beta subunits))

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