operative complications were more common with
bevacizumab. Addition of either carboplatin (60%
vs 44%; P = 0.0018) or bevacizumab (59% vs 48%;
P = 0.0089) significantly increased the pCR in
breast, whereas only carboplatin (54% vs 41%;
P = 0.0029) significantly raised the pCR in breast
and axilla. The study concluded that the addition of
either carboplatin or bevacizumab to neoadjuvant
AC/paclitaxel increased pCR rates, but whether
this will improve relapse-free survival or OS is un-
known.58
The addition of the antiangiogenic agent bevacizumab to adjuvant chemotherapy has also
been investigated. However, the results of the
randomized phase 3 BEATRICE trial were disappointing, showing no benefit of adding beva-
Table 1. Common Chemotherapy Regimens for Early-Stage Breast Cancer: HER2-Negative Disease
*TC chemotherapy:42 docetaxel 75 mg/m2 IV day 1 + cyclophosphamide 600 mg/m2 IV day 1 with myeloid growth factor support for all cycles
cycled every 21 days for 4 cycles
*Dose-dense AC followed by paclitaxel chemotherapy:30 doxorubicin 60 mg/m2 IV on day 1 + cyclophosphamide 600 mg/m2 IV day 1 with
myeloid growth factor support for all cycles, cycled every 14 days for 4 cycles, followed by paclitaxel 175 mg/m2 by 3-hour IV infusion day 1,
cycled every 14 days for 4 cycles
*Dose-dense AC followed by weekly paclitaxel chemotherapy:30 doxorubicin 60 mg/m2 IV on day 1 + cyclophosphamide 600 mg/m2 IV day
1 with myeloid growth factor support for all cycles, cycled every 14 days for 4 cycles, followed by paclitaxel 80 mg/m2 by 1-hour IV infusion
weekly for 12 weeks
Dose-dense AC chemotherapy:30 doxorubicin 60 mg/m2 IV on day 1 + cyclophosphamide 600 mg/m2 IV day 1 cycled every 14 days for 4 cycles
AC chemotherapy:43 doxorubicin 60 mg/m2 IV on day 1 + cyclophosphamide 600 mg/m2 IV day 1 cycled every 21 days for 4 cycles
AC followed by docetaxel chemotherapy:44 doxorubicin 60 mg/m2 IV on day 1 + cyclophosphamide 600 mg/m2 IV day 1 cycled every 21 days
for 4 cycles, followed by docetaxel 100 mg/m2 IV on day 1 cycled every 21 days for 4 cycles
AC followed by weekly paclitaxel chemotherapy:38 doxorubicin 60 mg/m2 IV on day 1 + cyclophosphamide 600 mg/m2 IV day 1 cycled every
21 days for 4 cycles, followed by paclitaxel 80 mg/m2 by 1-hour IV infusion weekly for 12 weeks
CAF chemotherapy:45 cyclophosphamide 100 mg/m2 orally days 1–14 + doxorubicin 30 mg/m2 IV days 1 and 8 + 5-fluourouracil 500 mg/m2
IV days 1 and 8 cycled every 28 days for 6 cycles
CEF chemotherapy:46 cyclophosphamide 75 mg/m2 orally days 1–14 + epirubicin 60 mg/m2 IV days 1 and 8 + 5-fluourouracil 500 mg/m2 IV
days 1 and 8 with cotrimoxazole support cycled every 28 days for 6 cycles
CMF chemotherapy:47 cyclophosphamide 100 mg/m2 orally days 1–14 + methotrexate 40 mg/m2 IV days 1 and 8 + 5-fluourouracil 600 mg/m2 IV
days 1 and 8 cycled every 28 days for 6 cycles
EC chemotherapy:48 epirubicin 100 mg/m2 IV day 1 + cyclophosphamide 830 mg/m2 IV day 1 every 21 days for 8 cycles
FAC chemotherapy:49 5-fluourouracil 500 mg/m2 IV days 1 and 8 or days 1 and 4 + doxorubicin 50 mg/m2 IV day 1 (or by 72-hour continuous
infusion) + cyclophosphamide 500 mg/m2 IV day 1 cycled every 21 days for 6 cycles
FAC followed by weekly paclitaxel chemotherapy:21 5-fluourouracil 500 mg/m2 IV days 1 and 8 or days 1 and 4 + doxorubicin 50 mg/m2 IV
day 1 (or by 72-hour continuous infusion) + cyclophosphamide 500 mg/m2 IV day 1 cycled every 21 days for 6 cycles followed by paclitaxel
80 mg/m2 by 1-hour IV infusion weekly for 12 weeks
FEC followed by weekly paclitaxel chemotherapy:50 5-fluourouracil 600 mg/m2 IV day 1 + epirubicin 90 mg/m2 IV day 1 + cyclophosphamide
600 mg/m2 IV day 1, cycled every 21 days for 4 cycles, followed by paclitaxel 100 mg/m2 IV infusion weekly for 8 weeks
FEC followed by docetaxel chemotherapy:51 5-fluourouracil 500 mg/m2 IV day 1 + epirubicin 100 mg/m2 IV day 1 + cyclophosphamide 500 mg/m2
IV day 1 cycled every 21 days for 3 cycles, followed by docetaxel 100 mg/m2 IV day 1 cycled every 21 days for 3 cycles
TAC chemotherapy:40 docetaxel 75 mg/m2 IV day 1 + doxorubicin 50 mg/m2 IV day 1 + cyclophosphamide 500 mg/m2 IV day 1 with myeloid
growth factor support for all cycles cycled every 21 days for 6 cycles
*Preferred regimens per National Comprehensive Cancer Network guidelines.21