TCH: Taxotere, carboplatin, and Herceptin

TCH (Taxotere or Taxol, carboplatin, and Herceptin) is a chemotherapy regimen used to treat HER2-positive breast cancer. It is a combination of two chemotherapy medicines:

• Docetaxel (Taxotere) or paclitaxel (Taxol), taxane chemotherapy medicines
• Carboplatin (Paraplatin), a platinum-type chemotherapy

And a targeted therapy:

• Trastuzumab (Herceptin)

Trastuzumab is a type of targeted therapy called a monoclonal antibody. It attaches to HER2 (human epidermal growth factor receptor 2) proteins and can kill HER2-positive cancer cells.

How TCH works

Docetaxel and paclitaxel work by damaging the structure or the “skeleton” that supports cancer cells. This stops the cancer cells from growing and dividing. Carboplatin stops cancer cells from reproducing by sticking to their DNA.

Trastuzumab (H) attaches to HER2 proteins on the surface of HER2-positive cancer cells, and blocks the signals that cause the cancer cells to multiply.

Who gets TCH

TCH is used as adjuvant therapy, after surgery, or neoadjuvant therapy, before surgery, for early-stage breast cancer that is

• HER2-positive and node-positive, when the cancer has traveled to lymph nodes
• HER2-positive, node-negative, when the cancer hasn’t traveled to lymph nodes

You and your doctor will discuss the best chemotherapy treatment for your situation.

How TCH is given

All three medicines are given by vein. Trastuzumab can be given first, followed by paclitaxel or docetaxel and carboplatin. It’s also common to receive all three medicines at once.

You will probably have 4 to 6 treatments of paclitaxel or docetaxel, and carboplatin every 3 weeks. You may also get treated on a weekly basis. Trastuzumab is then given weekly or every 3 weeks for a total of a year.

Side effects and things to remember

Different medicines have different side effects. You may not have every side effect related to each medicine of the combination therapy. Side effects of TCH may include:

• Nausea and vomiting
• Hair loss
• Risk of infection
• Mouth sores
• Fatigue
• Joint pain
• Nail changes
• Neuropathy, numbness or tingling in the hands or feet
• Heart issues

Before starting TCH, tell your doctor about any medicines you are taking, including vitamins, herbal supplements, and over-the-counter medicines, to make sure they won’t interfere with your chemotherapy treatment.

Trastuzumab can cause complications in pregnancy, so you should not become pregnant while taking it.

Be sure to talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. You can also go to our section on Side Effects for more information.