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35

NCCN Guidelines for Patients

®

:

Breast Cancer – Metastatic (STAGE IV), Version 2.2017

3

Treatment guide

Hormone receptor–negative cancers

Guide 7. Options for HER2-positive cancers

Preferred first-line agents

Length of a cycle

Trastuzumab + pertuzumab + docetaxel

21 days

Paclitaxel

21 days

with trastuzumab

7 or 21 days

and pertuzumab

7 or 21 days

Other agents

Length of a cycle

Ado-trastuzumab emtansine

21 days

Weekly paclitaxel and carboplatin

28 days

with trastuzumab

7 or 21 days

Paclitaxel and carboplatin

21 days

with trastuzumab

7 or 21 days

Weekly paclitaxel

7 days

with trastuzumab

7 or 21 days

Paclitaxel

21 days

with trastuzumab

7 or 21 days

Weekly docetaxel

7 days

with trastuzumab

7 or 21 days

Docetaxel

21 days

with trastuzumab

7 or 21 days

Vinorelbine

21 days

with trastuzumab

7 or 21 days

Capecitabine

21 days

with trastuzumab

7 or 21 days

Regimens after trastuzumab use

Length of a cycle

Lapatinib

Daily (not given in cycles)

with capecitabine

21 days

Capecitabine

21 days

with trastuzumab

7 or 21 days

Lapatinib

Daily (not given in cycles)

with trastuzumab

7 or 21 days

Trastuzumab + other agents

Depends on agents