- Abraxane (paclitaxel protein-bound particles for injectable suspension)
- Adriamycin (generic name, doxorubicin)
- Aredia (generic name, pamidronate disodium)
- Arimidex (generic name, anastrozole)
- Aromasin (generic name, exemestane)
- Chemotherapy Regimens
- Cytoxan (generic name, cyclophosphamide)
- Ellence (generic name, epirubicin)
- Evista (generic name, raloxifene)
- Fareston (generic name, toremifene)
- Femara (generic name, letrozole)
- Herceptin (generic name, trastuzumab)
- Megace (generic name, megestrol)
- Tamoxifen
- Taxol (generic name, paclitaxel)
- Taxotere (generic name, docetaxel)
- Xeloda (generic name, capecitabine)
- Zoladex (generic name, goserelin acetate)
- Zometa (generic name, zoledronic acid)
- Additional Resources and References
Arimidex (generic name, anastrozole) was FDA approved in 1996 to treat advanced (metastatic) breast cancer patients who have not responded well to treatment with the drug, tamoxifen. Clinical trials are currently underway to determine whether women with advanced breast cancer would benefit more from taking Arimidex than tamoxifen, either alone or in combination. Early results of a large clinical trial called ATAC (Arimidex, Tamoxifen, Alone or in Combination) showed no significant difference among women who received tamoxifen alone compared to those who received a combination of Armidex and tamoxifen, which suggests that tamoxifen should not be given in combination with Armidex. Researchers are also investigating Arimidex for treatment of early stage breast cancer.
Possible side effects of Arimidex include:
- General feeling of weakness
- Decreased energy level
- Headache
- Nausea
- Mild diarrhea
- Increased or decreased appetite
- Sweating
- Hot flashes
- Vaginal dryness
- Temporary hair thinning
Additional information and full prescribing information on Arimidex (courtesy of AstraZeneca).
Aromasin (generic name, exemestane) was FDA approved in 1999 to treat advanced (metastatic) breast cancer in post-menopausal women. Aromasin works by binding to the body's aromastase enzyme, an enzyme responsible for producing the hormone, estrogen. Many breast cancer cells depend on estrogen to grow and multiply quickly. Once aromasin has binded to the aromastase enzyme, estrogen cannot be produced by the enzyme. This lack of estrogen "starves" cancer cells, preventing them from growing. Aromasin is usually taken orally in pill form.
Possible side effects of Aromasin include:
- Hot flashes
- Nausea
- Fatigue
- Increased sweating
- Increased appetite
A 2007 study found that some breast cancer patients that take Aromasin (ore Femara) experience side effects such as joint and muscle pain and more than 10% of the patients in the study stopped treatement due to these effects. The researchers are investigating alternative treatments or methods to managing side effects in such patients. They suggest that tamoxifen may be a better choice for treatment of women who experience these side effects. Click here for more information.
Additional information and full prescribing information on Aromasin (courtesy of Pfizer).
Examples of chemotherapy combinations used to treat breast cancer include:
- cyclophosphamide (Cytoxan), methotrexate (Amethopterin, Mexate, Folex), and fluorouracil (Fluorouracil, 5-Fu, Adrucil) (this therapy is called CMF)
- cyclophosphamide, doxorubicin (Adriamycin), and fluorouracil (this therapy is called CAF)
- doxorubicin (Adriamycin) and cyclophosphamide (this therapy is called AC)
- doxorubicin (Adriamycin) and cyclophosphamide with paclitaxel (Taxol)
- doxorubicin (Adriamycin), followed by CMF
- cyclophosphamide, epirubicin (Ellence), and fluorouracil
(the brand name of the drug is shown in parenthesis)
Other chemotherapy drugs commonly used for treating women with breast cancer include docetaxel (Taxotere), vinorelbine (Navelbine), and gemcitabine (Gemzar), and capecitabine (Xeloda).
*Source: American Cancer Society
The side effects a breast cancer patient experiences while undergoing chemotherapy vary significantly depending on several factors, including the types of drugs used, their dosages, and the duration of treatment. The benefits of treating cancer with chemotherapy drugs outweighs the risk of complications for most women, and effects are often tolerable with proper care and rest.
Detailed information on chemotherapy for breast cancer patients.
Cytoxan (generic name, cyclophosphamide) is a chemotherapy drug commonly used to treat breast cancer and other cancers. Like Adriamycin, Cytoxan first disrupts cancer cells, then destroys them. Cytoxan is taken in tablets by mouth or intravenously (through the vein) over 30-60 minutes.
Common side effects may include:
- Decreased white blood cell count with increased risk of infection
- Hair loss
- Nausea and vomiting
- Loss of appetite
- Sores in mouth or on lips
- Diarrhea
- Ceasing of menstrual periods
Ellence (generic name, epirubicin) was approved by the FDA in 1999 to treat early-stage breast cancer after breast surgery (lumpectomy or mastectomy) in patients whose cancer has spread to the axillary (underarm) lymph nodes. Ellence helps reduce the likelihood that breast cancer will return (recur) and improves a patient's chances of survival. Ellence is given intravenously (through the vein) in combination with two other chemotherapy drugs, cyclophosphamide and fluorouracil.
Possible side effects of Ellence include:
- Nausea
- Vomiting
- Diarrhea
- Inflammation of the mouth (stomatitis)
- Hair loss
- Reduction in white blood cells (myelosuppression)
Additional information and full prescribing information on Ellence (courtesy of Pfizer).
Evista (generic name, raloxifene) belongs to a group of drugs called SERMs (selective estrogen-receptor modulators). Raloxifene was approved in December 1997 by the FDA to prevent osteoporosis. In 2007, based on results of several clinical trials, the FDA approved Evista to reduce the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk for invasive breast cancer. The trials showed that Evista reduced the risk of invasive breast cancer by 44 to 71 percent.
Despite these positive results, women should be aware that Evista can cause serious side effects including blood clots in the legs and lungs, and death due to stroke. Women with current or prior blood clots in the legs, lungs, or eyes should not take Evista. Other potential side effects include:
- hot flashes
- leg cramps
- swelling of the legs and feet
- flu-like symptoms
- joint pain
- sweating
The FDA cautions that Evista should not be taken by pre-menopausal women and women who are or may become pregnant because it may cause harm to the unborn baby. In addition, Evsita should not be taken with cholestyramine (a drug used to lower cholesterol levels) or estrogens. Finally, the FDA also warns that raloxifene does not provide complete prevention against breast cancer. Women should continue to get annual mammograms and clinical breast exams.
More information about Evista, including prescribing information, can be found on the Eli Lilly website.
