It is the consensus opinion of the Medical Oncology Reference Committee that this protocol is not considered best practice for this patient population due to insufficient evidence, availability of superior alternatives and unacceptable toxicity.
Treatment schedule summary
Drug |
Dose |
Route |
Day |
Epirubicin |
100 mg/m2 |
IV |
1 |
Fluorouracil |
500 mg/m2 |
IV |
1 |
CYCLOPHOSPHamide |
500 mg/m2 |
IV infusion |
1 |
Frequency: 21 days
Cycles: 3 or 4 (The phase II trials supporting this regimen used 4 cycles of FEC followed by 4 cycles of docetaxel 75 mg/m2. Given that OS and DFS are essentially equivalent whether chemotherapy is given in the adjuvant or neoadjuvant setting, there are arguments for using either 3 to 4 cycles of FEC followed by 3 to 4 cycles of docetaxel. It is the consensus of the reference committee that 3 to 4 cycles of docetaxel 100 mg/m2 be used for part 2 of the FEC-D regimen).
Notes:
For patients with HER-2 positive disease, trastuzumab may be given concurrently with docetaxel. Concurrent trastuzumab and an anthracycline has a higher risk of cardiac toxicity and should only be considered in patients with LVEF of 55% or more.