Treatments in Common Use for Metastatic Breast Cancer A - G

Four fundamentally different kinds of drugs are used to treat metastatic breast cancer:

· Cytotoxic chemotherapy: Cytotoxic (cell-killing) chemotherapy drugs are poisons that disrupt cancer cell functions, usually while a cell is dividing. Listed in yellow.

· Hormonal treatments: Hormonal treatments target breast cancers that grow in the presence of estrogen (and sometimes progesterone), and are used only for tumors that are ER+ and/or PR+ Listed in blue.

· Targeted therapies or biologics: Targeted therapies are biologics that target specific genes that make proteins that stimulate cell growth (oncogenes), and may only work if the tumor overexpresses certain proteins. Listed in pink.

· Other common medications: Intravenous bisphosphonates for bone metastases, and biological response modifiers that offer growth- factor support for patients undergoing chemotherapy. Listed in orange.

About this drug chart:

· This chart does not include supportive medications to treat symptoms of the cancer or side-effects of treatment, for example drugs given for pain and nausea.

· Each drug has three hyperlinks: 1) the manufacturer’s website (if the drug is still “on patent” and there is one); 2) the FDA-approved prescribing information that appears on the drug label, from RxList.com, and 3) patient-friendly information about use and side-effects at ChemoCare.com, developed by the Cleveland Clinic.

· Some drugs are approved for use in other cancers and other diseases.

· Doctors may use drugs to treat metastatic breast cancer even though they are not FDA approved for this use (called an "indication"). If there is high-quality research supporting this use, insurance and Medicare will usually reimburse. This is known as “off-label” use. Strictly speaking, much treatment for metastatic breast cancer is off-label.

· New research is constantly being presented at conferences or published in peer-reviewed oncology journals looking at whether these and other drugs, used singly or in combination, will benefit metastatic breast cancer patients. For recent updates, look in Research and Emerging Treatments.

· Also, see NCCN Practice Guidelines for Chemotherapy and Endocrine therapy in the treatment of metastatic breast cancer.

*Brand Name and Website*	*Generic Name*	*Drug Type and* *Administration*	*Prescribing* *Information*	*Links to Patient-Friendly info*
Abraxane^®	paclitaxel abumin-bound	Cytotoxic chemotherapy: Plant alkyloid, microtubule agent, Taxol dissolved in albumin, less toxic IV infusion, lessens allergic response	RxLabel	Abraxane at ChemoCare
Adriamycin^®	doxorubicin	Cytotoxic chemotherapy: Antibiotic anthracycline IV injection or infusion	RxLabel	Adriamycin at ChemoCare
Adrucil^®	5-fluorouracil [5-FU]	Cytotoxic chemotherapy: Alkylating agent, antimetabolite IV injection or infusion (see Xeloda)	RxLabel	5-FU at ChemoCare
Aranesp^®	darbopoeitin alfa	Biologic response modifier: Erythropoeisis-stimulating agent (treats anemia caused by chemotherapy) SubQ injection, IV infusion, 3 weekly	RxLabel	Aranesp at ChemoCare
Aredia^®	pamidronate	Bisphosphonate: decreases hypercalcemia, fractures, pain in patients with bone mets Standard of care for bone metastases IV infusion, monthly or less often	RxLabel	Aredia at ChemoCare
Arimidex^®	anastrozole	Hormone therapy: anti-estrogen Aromatase inhibitor Oral, daily	RxLabel	Arimidex at ChemoCare
Aromasin^®	exemestane	Hormone therapy: anti-estrogen Aromatase inhibitor Oral, daily	RxLabel	Aromasin at ChemoCare
Avastin^®	bevacizumab	Monoclonal antibody: targets VEG-F Anti-angiogenesis, targets tumor blood supply IV infusion, 3 weekly	RxLabel	Avastin at ChemoCare
Camptosar®	irinotecan	Cytotoxic chemotherapy: plant alkaloid, topoisomerase I inhibitor IV injection (investigational)	RxLabel	Irinotecan at ChemoCare
Cytoxan®	cyclophosphamide	Cytotoxic chemotherapy: Alkylating agent IV infusion or injection, oral	RxLabel	Cytoxan in ChemoCare
Doxil®	doxorubicin liposomal	Cytotoxic chemotherapy: Anthracycline bound to liposomes, alternative to Adriamycin, epirubicin IV infusion	RxLabel	Doxil in ChemoCare
Ellence®	epirubicin	Cytotoxic chemotherapy: Anthracycline, similar to Adriamycin, Doxil IV infusion	RxLabel	Epirubicin in ChemoCare
Evista®	raloxifene	Hormonal treatment: Selective estrogen receptor modulator (SERM) Oral daily (not used yet in MBC)	RxLabel	Raloxifene in ChemoCare
Faslodex®	fulvestrant	Hormonal therapy: SERD (selective estrogen receptor down-regulator) Monthly injection.	RxLabel	Faslodex in ChemoCare
Femara®	letrozole	Hormonal therapy: Aromatase inhibitor Oral daily.	RxLabel	Femara in ChemoCare
Gemzar®	gemcitabine	Cytotoxic chemotherapy: Antimetabolite IV infusion, 3 weekly	RxLabel	Gemzar in ChemoCare
Halaven®	eribulin mesylate	Cytotoxic chemotherapy: Non-taxane microtubule inhibitor, IV injection	RxLabel

(Continued) Standard Treatments H through Z

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Treatments in Common Use for Metastatic Breast Cancer A - G