From the Guidelines
AC chemotherapy, which combines Adriamycin (doxorubicin) and Cyclophosphamide, is typically administered intravenously in a hospital or outpatient setting every 2-3 weeks for a total of 4 cycles, with the standard dosage being doxorubicin 60 mg/m² and cyclophosphamide 600 mg/m² given on day 1 of each cycle, as supported by the study 1. The administration of AC chemotherapy involves several key steps to ensure safe and effective delivery.
- The dosage of doxorubicin and cyclophosphamide can vary, but the standard regimen is usually doxorubicin 60 mg/m² and cyclophosphamide 600 mg/m², as seen in the study 1.
- Each infusion session takes approximately 2-3 hours, with doxorubicin administered first as a slow IV push or short infusion over 15-30 minutes, followed by cyclophosphamide as an IV infusion over 30-60 minutes.
- Before chemotherapy begins, patients receive anti-nausea medications (antiemetics) to prevent side effects, and they should stay well-hydrated before and after treatment to help the body process and eliminate the drugs, particularly cyclophosphamide, as mentioned in the study 1.
- Blood tests are required before each cycle to ensure adequate blood cell counts and organ function, highlighting the importance of monitoring and adjusting treatment as necessary, as discussed in the study 1. This regimen is effective because doxorubicin intercalates with DNA to prevent cell replication while cyclophosphamide is an alkylating agent that damages DNA, creating a powerful combination that targets rapidly dividing cancer cells through different mechanisms, as supported by the studies 1.
From the Research
Administration of AC Chemotherapy
- AC (Adriamycin (doxorubicin) and Cyclophosphamide) chemotherapy can be administered on an every 3-week schedule (standard dose) or every 2-week dose dense (dd) schedule 2.
- The standard dose of AC is typically administered until a certain number of cycles are completed, after which other chemotherapy agents like paclitaxel may be introduced 2, 3.
- Dose-dense AC followed by dose-dense nab-paclitaxel has been shown to be safe and effective in women with early-stage breast cancer 3.
- AC chemotherapy can be administered intravenously, and patients may receive antiemetic medications like NEPA to prevent chemotherapy-induced nausea and vomiting (CINV) 4.
Dosage and Schedule
- The dosage of doxorubicin in AC chemotherapy is typically 60 mg/m(2) 3.
- The dosage of cyclophosphamide in AC chemotherapy is typically 600 mg/m(2) 3.
- The schedule of AC chemotherapy can vary, but common schedules include every 3 weeks or every 2 weeks 2, 3.
Safety and Efficacy
- AC chemotherapy has been shown to be safe and effective in women with breast cancer, with manageable adverse events 2, 3, 4.
- The addition of paclitaxel to AC chemotherapy has been shown to improve disease-free survival (DFS) but not overall survival (OS) in patients with node-positive breast cancer 5.
- Dose-dense AC-taxane therapy may increase rates of anemia and the need for erythropoietin, and decrease rates of neutropenia 6.