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28

NCCN Guidelines for Patients

®

:

Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017

3

Chemotherapy and HER2 treatment Overview

How chemotherapy works

The types of chemotherapy differ in the way they

treat cancer. Some kill cancer cells by damaging

their DNA or by disrupting the making of DNA. Others

interfere with cell parts that are needed for making

new cells. Thus, no new cells are made to replace

dying cells. The four types of chemotherapy used to

treat stage III breast cancer are listed in

Guide 2

.

Some chemotherapy drugs work when cells are

in an active growth phase.

See Figure 9

. During

the active growth phase, cells grow and divide to

form a new cell. Chemotherapy drugs that disrupt

the growth phase work well for cancer cells that are

growing and dividing quickly. Other chemotherapy

drugs work whether cells are in a growth or resting

phase.

How HER2 treatment works

Antibodies are Y-shaped proteins that are made by

your body. They help your body’s disease-fighting

(immune) system work. Monoclonal antibodies are

antibodies made in a lab. They are used to treat

cancer.

There are monoclonal antibodies that treat HER2-

positive breast cancer. They are trastuzumab and

pertuzumab. Trastuzumab is sold as Herceptin

®

, and

pertuzumab as Perjeta

®

. Trastuzumab is used with

chemotherapy. Pertuzumab may be added.

HER2 monoclonal antibodies are a type of targeted

therapy. They prevent HER2 from sending signals

that start the growth of cancer cells. Trastuzumab

works by attaching to and disabling HER2 receptors.

See Figure 10

. Pertuzumab works like trastuzumab

but attaches to a different part of the receptor. These

two drugs also attract immune cells that help to kill

the cancer cells.

Guide 2. Chemotherapy types

Type

Generic name

Brand name

How they work

Alkylating agents

Carboplatin

Damage DNA by adding a

chemical to it

Cyclophosphamide

Anthracyclines

Doxorubicin

Damage and disrupt the

making of DNA

Epirubicin

Ellence

®

Antimetabolites

Fluorouracil

Prevent the “building

blocks” of DNA from being

used

Methotrexate

Microtubule inhibitors

Docetaxel

Taxotere

®

Stop a cell from dividing

into two cells

Paclitaxel

Taxol

®

, Abraxane

®