AC-T

Introduction

A chemotherapy regimen consisting of doxorubicin hydrochloride (Adriamycin) and cyclophosphamide, followed by paclitaxel (Taxol), administered on either a dose-dense or sequential schedule and used as an adjuvant treatment for breast cancer.

A = Doxorubicin Hydrochloride (Adriamycin)

C = Cyclophosphamide 

D = paclitaxel (Taxol)

Experts have approved Doxorubicin hydrochloride to use it alone or with other drugs to treat:

  • Acute lymphoblastic leukaemia (ALL)
  • Acute myeloid leukaemia (AML)  
  • Breast cancer- Experts use it after surgery to remove the primary tumour in women whose cancer has spread to the lymph nodes under the arm. However, they use it with other drugs. And in patients with metastatic breast cancer.
  • Gastric (stomach) cancer that is metastatic.
  • Hodgkin lymphoma
  • Neuroblastoma is metastatic.
  • Non-Hodgkin lymphoma  
  • Non-small celllung cancer is metastatic.
  • Ovarian cancer that is metastatic.
  • Small cell lung cancer that is metastatic.
  • Soft tissue and bone sarcomasthat are metastatic.
  • Thyroid cancer that is metastatic.
  • Transitional cell bladder cancerthat is metastatic.
  • Wilms tumor that is metastatic.

AC-T is a standard regimen for breast cancers that require treatment with chemotherapy. Women with cancer of a higher grade and younger women often get this combination. Experts can also use it in people who have had a recurrence depending on the medicines you received for early-stage disease.

The doctors can give AC-T after surgery as adjuvant therapy, or before surgery as neoadjuvant therapy. Sometimes they give the AC portion before surgery and the taxane after, based on cancer that remains in the breast after surgery.

How AC-T works?

Doxorubicin damages the DNA inside the cancer cells. The damage stops the cells from dividing, which causes them to die.

Cyclophosphamide attaches to and damages the DNA in cancer cells when they are in their resting phase (not dividing). After their DNA is damaged, the cells can’t keep dividing, and their growth slows or stops.

Paclitaxel works by damaging the structure or the “skeleton” that supports cancer cells. This stops the cancer cells from growing and dividing. Docetaxol (Taxotere)  works in a similar way and is sometimes used instead of paclitaxel.

How AC-T is Give?

AC-T is usually given in eight treatments, once every 3 weeks. The first four treatments are AC, and the next four are paclitaxel(T). Sometimes the paclitaxel is given weekly at a lower dose instead of every 3 weeks. The whole course of AC-T treatment takes about 5 months.AC-T is more commonly given on a dose-dense schedule of AC every 2 weeks for a total of four cycles, followed by T every 2 weeks for a total of four cycles. Both AC and T are given by vein into your hand or arm. 

Sometimes docetaxel is used instead of paclitaxel. The AC portion is given once every three weeks followed by docetaxel, which is also given once every three weeks.

Side effects:

Side effects of AC-T may include:

  • Low red and white blood cell counts 
  • Infection
  • Nausea and vomiting
  • Loss of appetite
  • Hair loss
  • Neuropathy
  • Mouth sores
  • Nail and skin changes
  • Bladder irritation
  • Bone pain
  • diarrhea
  • Increased risk of sunburn
  • Menopausal symptoms
  • Fatigue
  • Heart damage
  • Bruising or bleeding

Be sure to tell the doctor about any medicines you are taking, including vitamins, herbal supplements and over-the counter-medicines, to make sure they will not interfere with the chemotherapy treatment. Your doctor will check your blood before you start treatment. If your blood count is low then your treatment may be delayed.

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them.