Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Treatment regimen

Weekly paclitaxel with trastuzumab (APT regimen)

Adjuvant treatment of small node-negative HER2-positive breast cancer

Updated: 28 October 20261 min read2 references

Summary for doctors

  • HER2-positive tumour up to 3 cm without nodal involvement (pN0 or pN1mi) [1].
  • A low-toxicity regimen with an excellent outcome: 3-year invasive disease-free survival 98.7% [1].

Dose and schedule

APT (TH)

Small node-negative HER2-positive breast cancer; adjuvant

Small node-negative HER2-positive breast cancer; adjuvant

DrugDoseRouteSchedule
Phase 1: 12 weeks
Paclitaxel80 mg/m²IVWeekly
Trastuzumab4 mg/kg (first dose), then 2 mg/kgIVWeekly
Phase 2: up to one year
Trastuzumab6 mg/kgIV (or 600 mg subcutaneous)Every 21 days
Cycle length
Weekly paclitaxel and trastuzumab for 12 weeks; then trastuzumab every 21 days
Duration
Trastuzumab one year in total

Doses as in the APT study [1].

Dose source: [2].

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

  • Paclitaxel premedication; antiemetics for low emetogenicity.

Monitoring and dose adjustment

  • Left ventricular ejection fraction (echo or MUGA) before starting and every 3 months during anti-HER2 treatment.
  • Weekly blood counts in the first 12 weeks; neuropathy.

Main evidence

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APT: in 406 patients, 3-year invasive disease-free survival was 98.7%, and symptomatic heart failure occurred in 0.5% [1].

Related cancer types

Breast cancer

Treatment regimens (physicians)

AC followed by paclitaxel (dose-dense and weekly)TC regimen (docetaxel and cyclophosphamide): dose and scheduleTCHP regimen: dose and schedule in HER2-positive breast cancerKEYNOTE-522 regimen: pembrolizumab and chemotherapy in triple-negative breast cancerTrastuzumab emtansine (T-DM1, Kadcyla): dose and scheduleTrastuzumab deruxtecan (T-DXd, Enhertu): dose and monitoringAdjuvant capecitabine after neoadjuvant treatment (CREATE-X)Sacituzumab govitecan (Trodelvy)Pembrolizumab with chemotherapy in metastatic triple-negative breast cancer (KEYNOTE-355)

Physician tools and lessons

Cumulative Anthracycline Dose and Doxorubicin Equivalents10 cheap steps that save patients' livesBone-modifying agents in cancer: bone metastases, adjuvant use and osteonecrosis of the jawGermline genetic testing in cancer: who, and which genes?Management of brain metastasesFertility preservation before cancer treatmentMalignant pleural effusion: drainage, pleurodesis or an indwelling catheterCancer during pregnancy: chemotherapy and decisions

References

2 references
Show all referencesClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancerTolaney SM, Barry WT, Dang CT, et al · N Engl J Med · 2015;372:134-41
    DOIPubMed Back to text: 1 2 3 4
  2. 2
    HERCEPTIN (TRASTUZUMAB) — Prescribing InformationGenentech, Inc · FDA label · 2026
    Source Back to text

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/paclitaxel-trastuzumab-apt/

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