A comprehensive approach to breast cancer treatment may include chemotherapy, radiation therapy, surgery and other approaches, depending on a patient’s unique diagnosis. For women with HER2-positive breast cancer — a type of the disease which accounts for about 15% of all new diagnoses each year — TCHP chemotherapy is a common first step on their treatment journey.
“TCHP is the current recommended therapy that we administer prior to surgery for many patients with higher risk, early-stage HER2-positive breast cancer,” explains Hannah Chang, M.D., a medical oncologist and breast cancer expert at City of Hope® Cancer Center Duarte.
In most cases, Dr. Chang adds, she prescribes TCHP for HER2-positive patients with larger tumors or whose cancer has already started to spread to the lymph nodes.
This article covers the basics on TCHP as a chemotherapy treatment for breast cancer, including:
- What is TCHP chemo?
- What conditions is it used for?
- How is it administered?
- The TCHP chemo regimen
- TCHP chemo side effects
- Managing adverse effects of TCHP
If you or a loved one has been diagnosed with breast cancer and would like to schedule an appointment or get a second opinion, call us 24/7 at 877-460-4673.
What Is TCHP Chemo?
“TCHP chemotherapy is a regimen that consists of two chemotherapy agents and two HER2 targeted therapies,” Dr. Chang says. The first letters of these four medications are what give this particular combination its name:
- Taxotere® (docetaxel), a chemotherapy drug
- Carboplatin (Paraplatin®), a chemotherapy drug
- Herceptin® (trastuzumab), a targeted therapy
- Perjeta® (pertuzumab), a targeted therapy
The two chemotherapy drugs work to slow the growth of a tumor or to destroy cancer cells. The targeted therapies disrupt the chemical signals that tell cancer cells to divide and spread.
While a combination of the first three therapies — referred to as TCH — was used for many years to treat HER2-positive breast cancer, more recent studies found that adding Perjeta® improved patient outcomes even more.
What Conditions Is It Used for?
TCHP chemo is used to treat HER2-positive breast cancer, a fast-growing and invasive type of the disease. Patients with HER2-positive breast cancer produce too much of a protein called human epidermal growth factor 2 (or HER2), which can contribute to their cancer’s growth.
“I reserve TCHP only for HER2-positive patients, however, the chemotherapy agents are used for other types of breast cancer,” says Dr. Chang. “In the case of TCHP together, this is a particularly effective option because the Taxotere® medication works synergistically with the targeted therapy drugs, Herceptin® and Perjeta®.”
She adds that, regardless of their response to TCHP, almost all patients still undergo surgery after completing their chemo regimen.
How Is It Administered?
Patients receive TCHP chemo intravenously, meaning the drugs are infused into their bodies through a thin, narrow tube. This delivers the medications directly into the bloodstream.
The TCHP Chemo Regimen
Most people receive TCHP chemotherapy at a hospital or comprehensive cancer center like City of Hope. TCHP is usually administered:
- Over six cycles
- Once every three weeks
- Over the course of around 18 weeks
During each cycle, patients receive each drug for a specific period of time, which helps ensure the medication is as effective as it can be while minimizing any side effects.
TCHP Chemo Side Effects
One drawback to TCHP chemo is the potential for side effects.
“Unfortunately, TCHP is a tough regimen for patients,” Dr. Chang says, explaining that some of the most common issues she sees include:
- Diarrhea
- Neuropathy, or nerve damage, which may cause numbness or tingling sensations in areas like the fingers
- Low blood counts
- A compromised immune system
TCHP chemotherapy can also cause side effects that are common to many types of chemo treatments, including hair loss, nausea and fatigue.
Managing Adverse Effects of TCHP
Thankfully, many of these side effects can be managed for the duration of a patient’s chemo treatment.
“We offer growth factor support, which stimulates the bone marrow to make more cells, helping reduce the complications of having a depressed immune system,” says Dr. Chang.
Other ways patients may help manage TCHP side effects include:
- Taking over-the-counter diarrhea medications
- Getting enough rest and drinking enough water
- Using gentle shampoos, combs or hairbrushes
- Staying out of the sun to protect the skin
- Washing hands frequently to avoid germs and infections
Neuropathy is another frequent side effect, but Dr. Chang has a simple recommendation.
“We encourage icing the hands and feet during therapy to prevent neuropathy,” she says, “but if it does develop, we manage it with dose reductions or with medications to help with nerve pain.”
If you or a loved one has been diagnosed with breast cancer and would like to schedule an appointment or get a second opinion, call us 24/7 at 877-460-4673.