TC Regimen (Docetaxel + Cyclophosphamide)
| Feature | Details |
|---|---|
| Full Name | Docetaxel + Cyclophosphamide |
| Typical Indication | Adjuvant chemotherapy for early-stage, HER2-negative breast cancer, especially in node-negative or low-node–positive disease; also used in some other solid tumors. |
| Goal | Reduce recurrence risk and improve survival after surgery. |
| Typical Dosing (Adjuvant Breast Cancer) | Docetaxel 75 mg/m² IV + Cyclophosphamide 600 mg/m² IV, both on Day 1 every 21 days × 4 cycles. |
| Mechanism | – Docetaxel: Taxane that inhibits microtubule depolymerization → mitotic arrest. – Cyclophosphamide: Alkylating agent causing DNA crosslinking → apoptosis. |
| Advantages | – Non-anthracycline regimen (avoids doxorubicin cardiotoxicity) – Shorter duration (4 cycles vs. 6+) |
| Key Toxicities | – Neutropenia (high risk — primary G-CSF prophylaxis recommended) – Fatigue – Alopecia – Myalgias/arthralgias – Docetaxel-specific: fluid retention, nail changes, neuropathy – Cyclophosphamide-specific: hemorrhagic cystitis (rare at adjuvant doses), SIADH |
| Supportive Care Considerations | – G-CSF prophylaxis (e.g., pegfilgrastim) is standard due to high FN risk. – Dexamethasone premedication for docetaxel to reduce hypersensitivity and edema. – Hydration for cyclophosphamide. |
| Alternatives | AC → T (Anthracycline + Taxane) regimens if higher-risk disease and patient can tolerate anthracyclines. |