AC (doxorubicin, cyclophosphamide)
Checked 2026-09-09
Adjuvant chemotherapy for early breast cancer, four cycles, usually followed by a taxane (AC-T) or given dose-dense every 14 days
Also called AC, Adriamycin-cyclophosphamide.
One cycle
every 21 days × 4 · about 12 weeks in totalComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Doxorubicin Cytotoxic chemotherapy (anthracycline) | 60 mg/m² | IV | D1 | |
Cyclophosphamide Alkylating agent (oxazaphosphorine prodrug) | 600 mg/m² | IV | D1 |
Cycles
4
21-day cycle
Emetogenicity
High (>90%)
G-CSF
Consider (10-20% FN risk)
Notes
- B-15 established that two months of AC matched six months of CMF, making AC the anthracycline backbone of adjuvant breast cancer therapy.
- Cumulative doxorubicin is limited to 240 mg/m² over four cycles; check LVEF.
Used in
HR-positive / HER2-negative breast cancerHER2-positive breast cancerTriple-negative breast cancer (TNBC)
Products
Source
Fisher (NSABP B-15), JCO 1990: four cycles of AC equal to six months of CMF
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.
Other regimens for these cancers
Everolimus
Advanced progressive NET (RADIANT-3, RADIANT-4); RCC and HR-positive breast cancer after prior therapy
every 28 days
Dose-dense AC → T
Node-positive or high-risk early breast cancer, adjuvant or neoadjuvant
every 14 days × 4
TC (docetaxel + cyclophosphamide)
Early breast cancer when an anthracycline is not wanted
every 21 days × 4
KEYNOTE-522 (pembrolizumab + chemotherapy, then adjuvant pembrolizumab)
Stage II-III triple-negative breast cancer
every 21 days × 4
TCHP
Stage II-III HER2-positive breast cancer, neoadjuvant
every 21 days × 6
APT (weekly paclitaxel + trastuzumab)
Stage I HER2-positive breast cancer, node-negative, tumour 3 cm or smaller
weekly × 12
THP (docetaxel + trastuzumab + pertuzumab)
HER2-positive metastatic breast cancer first line, then HP maintenance
every 21 days
Trastuzumab deruxtecan 5.4 mg/kg
HER2-positive metastatic breast cancer second line; HER2-low or ultralow after chemotherapy or endocrine therapy; HER2-mutant NSCLC
every 21 days