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

TCHP regimen: dose and schedule in HER2-positive breast cancer

Docetaxel, carboplatin, trastuzumab and pertuzumab every 3 weeks, 6 cycles

Updated: 28 October 20261 min read4 references

Summary for doctors

  • Stage 2 and 3 HER2-positive breast cancer, before surgery [1].
  • Anthracycline-free; less cardiac toxicity than AC-containing regimens [2].
  • After surgery: if the response was not complete, trastuzumab emtansine for 14 cycles [3]; otherwise continue trastuzumab (± pertuzumab) to one year.
  • Diarrhoea is common.

Dose and schedule

TCHP

HER2-positive breast cancer, before surgeryCycle length: Every 21 days

HER2-positive breast cancer, before surgery

DrugDoseRouteSchedule
Docetaxel75 mg/m²IVDay 1
CarboplatinAUC 6IVDay 1
Trastuzumab8 mg/kg (first dose), then 6 mg/kgIV (or 600 mg subcutaneous)Day 1
Pertuzumab840 mg (first dose), then 420 mgIVDay 1
Cycle length
Every 21 days
Duration
6 cycles before surgery; anti-HER2 treatment one year in total

Doses as in the TCHP arm of TRYPHAENA [1].

Dose source: [4].

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

  • Docetaxel premedication (dexamethasone for 3 days).
  • Antiemetics: carboplatin AUC 6: NK1, 5-HT3 and dexamethasone.
  • G-CSF prophylaxis in many centres; loperamide on hand for diarrhoea.

Monitoring and dose adjustment

  • Left ventricular ejection fraction (echo or MUGA) before starting and every 3 months during anti-HER2 treatment; a fall of 10 points or more to below 50% means a temporary hold and a repeat echo after 3 weeks.
  • Blood counts and creatinine before each cycle (carboplatin with the Calvert formula).
  • If a trastuzumab dose is more than a week late, repeat the loading dose (8 mg/kg).

Main evidence

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TRYPHAENA: pathological complete response with TCHP was about 66%, and symptomatic heart failure was rare [1]. BCIRG 006: adjuvant TCH was nearly as effective as AC followed by TH, with less cardiac toxicity and leukaemia [2]. KATHERINE: in residual disease, T-DM1 roughly halved the risk of invasive recurrence [3].

Related cancer types

Breast cancer

Treatment regimens (physicians)

AC followed by paclitaxel (dose-dense and weekly)TC regimen (docetaxel and cyclophosphamide): dose and scheduleWeekly paclitaxel with trastuzumab (APT regimen)KEYNOTE-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

4 references
Show all references, 2 with a study cardClose 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
    Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracycline-containing and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer: a randomized phase II cardiac safety study (TRYPHAENA)Schneeweiss A, Chia S, Hickish T, et al · Ann Oncol · 2013;24:2278-84
    DOIPubMed Back to text: 1 2 3
  2. 2
    Adjuvant trastuzumab in HER2-positive breast cancerSlamon D, Eiermann W, Robert N, et al · N Engl J Med · 2011;365:1273-83
    Study cardDOIPubMed Back to text: 1 2
  3. 3
    Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancervon Minckwitz G, Huang CS, Mano MS, et al · N Engl J Med · 2019;380:617-628
    Study cardDOIPubMed Back to text: 1 2
  4. 4
    PERJETA (PERTUZUMAB) — 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/tchp/

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