How does Adriamycin and Cytoxan (AC chemo) work for Breast Cancer?
- AC is a common, effective, combination chemotherapy treatment commonly used to treat early-stage localized breast cancer
- AC contains two chemotherapy agents Adriamycin (doxorubicin) and cyclophosphamide which are usually given together or sequentially with weekly paclitaxel (Taxol) or docetaxel (Taxotere), to create a combination called AC-T or ACT
- Adriamycin works by damaging DNA at any point in the cell cycle whereas cyclophosphamide damages DNA during the resting phase of the cell cycle. Both prevent cell replication
- Sequential Adriamycin-cyclophosphamide therapy with paclitaxel or docetaxel (AC-T) was declared by a 2015 review to likely be the most effective treatment regimen of early-stage breast cancer regardless of hormone status.
The combination of Adriamycin and cyclophosphamide is considered a “tried-and-true”, common, regimen to treat localized breast cancer. It is often referred to as simply “AC”. Cytoxan, the branded version of cyclophosphamide has been discontinued in the United States. Generic versions of cyclophosphamide are still available.
How does Adriamycin and cyclophosphamide work?
Adriamycin (doxorubicin) belongs to a class of cancer medicines called anthracycline antibiotics. It works by damaging the DNA inside cancer cells so they cannot replicate. It works at any point in the cell cycle.
Cyclophosphamide belongs to a class of cancer medicines called alkylating agents. Cyclophosphamide prevents cancer cells from dividing by cross-linking DNA strands and decreasing DNA synthesis. It works during the resting phase of the cancer cell cycle.
When would Adriamycin and cyclophosphamide be used?
The combination of Adriamycin and cyclophosphamide may be used to treat early-stage localized breast cancer that may or may not have spread to the lymph nodes. It is usually followed by weekly paclitaxel (Taxol) or docetaxel (Taxotere), to create a combination regimen referred to as AC-T (when given sequentially) or ACT (when given concurrently).
Adriamycin and cyclophosphamide may also be given when breast cancer has returned, or for breast cancer that has spread to distant areas of the body, such as the bones, liver, lungs or brain.
Related questions
- What is the chemo drug called the Red Devil?
- What is the strongest chemotherapy drug for breast cancer?
- Chemo side effects: What should I expect and how to cope?
How is AC for breast cancer given?
The combination of Adriamycin and cyclophosphamide are usually given as separate infusions on the same day, followed by a rest period of 2 or 3 weeks. The cycle is usually repeated 4 to 6 times over 3 to 5 months.
How effective is AC or AC-T for breast cancer?
A review in 2015 reported that sequential Adriamycin-cyclophosphamide therapy followed by paclitaxel or docetaxel appears to be the most effective treatment regimen of early-stage breast cancer regardless of hormone status.
What are the side effects of AC for breast cancer?
Common side effects of combination Adriamycin and cyclophosphamide treatment include:
- Bladder irritation, pink or red urine
- Diarrhea or constipation
- Hair loss
- Low blood cell counts
- Menopausal symptoms
- Mouth sores
- Nail changes
- Nausea and vomiting
- Tiredness
- Skin changes.
What are the long-term side effects of AC for breast cancer?
Long-term side effects of Adriamycin may include:
- Cardiotoxicity
- Secondary cancers
- Amenorrhea in women older than 40
- Gastrointestinal problems
- Neurological problems.
References
- Adriamycin (doxorubicin) for injection. FDA https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/062921s022lbl.pdf
- Doxorubicin (Rx) Medscape.com https://reference.medscape.com/drug/doxorubicin-342120
- Rahman AM, Yusuf SW, Ewer MS. Anthracycline-induced cardiotoxicity and the cardiac-sparing effect of liposomal formulation. Int J Nanomedicine. 2007;2(4):567–583.
- Rheingold SR, Neugut AI, Meadows AT. Therapy-Related Secondary Cancers. In: Kufe DW, Pollock RE, Weichselbaum RR, et al., editors. Holland-Frei Cancer Medicine. 6th edition. Hamilton (ON): BC Decker; 2003. Available from: https://www.ncbi.nlm.nih.gov/books/NBK13999/
- Doxorubicin. Drugs.com Oct 7, 2019. https://www.drugs.com/dosage/doxorubicin.html
- Cyclophosphamide. Drugs.com Oct 20, 2019, https://www.drugs.com/ppa/cyclophosphamide.html
- Hortobagyi GN, Buzdar AU, Marcus CE, Smith TL. Immediate and long-term toxicity of adjuvant chemotherapy regimens containing doxorubicin in trials at M.D. Anderson Hospital and Tumor Institute. NCI Monogr. 1986;(1):105-9.
- Fujii T, Le Du F, Xiao L, et al. Effectiveness of an Adjuvant Chemotherapy Regimen for Early-Stage Breast Cancer: A Systematic Review and Network Meta-analysis. JAMA Oncol. 2015;1(9):1311–1318. doi:10.1001/jamaoncol.2015.3062
Read next
How long does chemo take? Sessions, cycles, and recovery time?
The duration of chemotherapy varies significantly based on cancer type, treatment goals, and individual patient health. Some patients may complete treatment in a few months, while others require therapy for a year or longer.
Continue reading
Radiation vs. Chemo: Which cancer treatment is right for you?
Chemotherapy treats cancer throughout the body, while radiation targets specific areas. Each approach has unique benefits depending on the type and stage of cancer, as well as your overall health.
Continue reading
How soon will my hair grow back after chemotherapy?
After finishing chemotherapy, some may notice fine, soft hair appearing as early as 3 to 6 weeks after treatment ends. It can take several months for your hair to return to its previous length and thickness, and there may be temporary changes in texture or color.
Continue readingSee also:
Aimovig
Learn about Aimovig (erenumab-aooe) a once-monthly, injectable medication that can be ...
Botox
Botox is used for cosmetic purposes and to treat overactive bladder symptoms, urinary incontinence ...
Trodelvy
Trodelvy (sacituzumab govitecan) is a targeted therapy used to treat breast cancer (triple-negative ...
Nurtec ODT
Nurtec ODT (rimegepant) is used to treat acute migraines and prevent episodic migraines, by ...
Vyepti
Vyepti (eptinezumab-jjmr) is used for the preventive treatment of migraine. Includes Vyepti ...
Depakote
Depakote is used to treat various types of seizure disorders. Learn about side effects ...
Topamax
Topamax (topiramate) is used to prevent seizures in adults and children and to prevent migraine ...
Emgality
Emgality (galcanezumab-gnlm) is a CGRP antagonist for the preventive treatment of migraine and for ...
Inderal
Inderal (propranolol) is used to treat angina, high blood pressure and heart rhythm disorders ...
Related medical questions
- Will I lose my hair during chemotherapy treatment?
- How Does Chemotherapy Work for Multiple Myeloma?
- What is chemo brain and how long does it last?
- What is EPOCH/R-EPOCH chemo regimen and how is it used?
- How soon can you start chemo after port placement?
- What is ABVD chemo regimen and how is it used for lymphoma?
- What are CHOP and R-CHOP chemotherapy regimens?
- How is Lartruvo administered?
- What is the lifetime or cumulative dose for Adriamycin?
- What are the long-term side effects of Adriamycin?
- Does Adriamycin cause heart failure?
- What is the TC chemo regimen and how does it treat breast cancer?
Drug information
Related support groups
- Doxorubicin (18 questions, 11 members)
- Cyclophosphamide (9 questions, 13 members)
- Adriamycin (9 questions, 8 members)
- Breast Cancer (130 questions, 311 members)