Neoadjuvant/ Adjuvant Treatments
Recommendations on reporting on HER-2 status in breast cancer patient (PDF, 452 KB, 1 page)
Oncotype-DX
Use of Oncotype DX for gene expression profiling to support chemotherapy decision making in patients with Hormone Receptor positive, HER2 negative, lymph node negative early stage breast cancer was recommended by the NCCP Technology Review Committee in August 2011 in line with eligibility guidelines drafted by the Irish Society of Medical Oncology.
ISMO Evidence Based Guideline Oncotype DX (PDF, 751 KB, 40 pages)
The use of Oncotype DX has been extended to patients with Hormone Receptor positive, HER2-negative, lymph node positive patients (1-3nodes) breast cancer patients in line with the recommendation of the NCCP Systemic Anti-Cancer Therapy Breast Clinical Advisory Group (November 2019).
Abemaciclib Therapy
Indication
00619a
Abemaciclib in combination with endocrine therapy for the adjuvant treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-positive early breast cancer at high risk of recurrence.
Anastrozole Monotherapy
Indication
00254b
Adjuvant treatment of hormone receptor positive early invasive breast cancer in post-menopausal women.
00254c
Adjuvant treatment of hormone receptor-positive early invasive breast cancer in postmenopausal women who have received 2 to 3 years of adjuvant tamoxifen.
Capecitabine Monotherapy
Indication
00216f
Adjuvant treatment of stage I to IIIB, triple negative breast cancer (TNBC) in patients with residual invasive disease after neoadjuvant chemotherapy treatment
CARBOplatin (AUC6) and Weekly PACLitaxel (80mg/m2) followed by Dose Dense DOXOrubicin cycloPHOSphamide Therapy-Triple Negative Breast Cancer Therapy
CARBOplatin (AUC 2) weekly and PACLitaxel 80mg/m2 followed by Dose Dense DOXOrubicin cycloPHOSphamide Therapy - Triple Negative Breast Cancer Therapy
cycloPHOSphamide (IV) Methotrexate and 5-Fluorouracil (CMF) Therapy 21 day
Indication
00381a
Adjuvant treatment for breast carcinoma in patients who are considered unsuitable for anthracycline therapy.
cycloPHOSphamide (IV) Methotrexate and 5-Fluorouracil (CMF) Therapy 28 day
Indication
00378a
Adjuvant treatment for breast carcinoma in patients who are considered unsuitable for anthracycline therapy.
cycloPHOSphamide (oral) Methotrexate and 5-Fluorouracil (CMF) Therapy
Indication
00377a
Adjuvant treatment for breast carcinoma in patients who are considered unsuitable for anthracycline therapy.
Dose Dense Doxorubicin, cycloPHOSphamide (AC 60/600) 14 day followed by weekly PACLitaxel (80) and Trastuzumab 21 day Therapy (DD AC-TH)
Indication
00745a
Adjuvant Treatment of HER2 positive, High Risk Node Negative or Node Positive Breast Cancer
00745b
Neoadjuvant Treatment of HER2 positive, High Risk Node Negative or Node Positive Breast Cancer
DOCEtaxel /cycloPHOSphamide (TC) Therapy-21 day
Indication
00250a
Adjuvant treatment of patients with high risk node-positive or node-negative early operable breast cancer.
DOCEtaxel, CARBOplatin and Trastuzumab (TCH)-21 days
DOXOrubicin, and Cyclophosphamide (AC 60/600)Therapy - 21 day
DOXOrubicin, cycloPHOSphamide (AC 60/600) 21 day followed by weekly PACLitaxel (80) Therapy (AC-T)
Indication
00260a
Neoadjuvant or Adjuvant Treatment of High Risk Node
Negative or Node Positive Breast Cancer
Dose Dense DOXOrubicin,Dose Dense DOXOrubicin, Cyclophosphamide (AC 60/600) 14 day followed by PACLitaxel (80) 7 day Therapy (DD AC-T) cycloPHOSphamide (AC 60/600) 14 day followed by PACLitaxel (80) 7 day Therapy (DD AC-T)
Indication
00485a
Adjuvant Treatment of High Risk Node Negative or Node Positive Breast Cancer
00485b
Neoadjuvant Treatment of High Risk Node Negative or Node Positive Breast Cancer.
Dose Dense DOXDose Dense DOXOrubicin, Cyclophosphamide (AC 60/600) 14 day followed by PACLitaxel (175) 14 day Therapy (DD AC-T)Orubicin, cycloPHOSphamide (AC 60/600) 14 day followed by PACLitaxel (175) 14 day Therapy (DD AC-T)
Indication
00278a
Adjuvant treatment of High Risk Node Negative or Node Positive Breast Cancer
00278b
Neoadjuvant treatment of High Risk Node Negative or Node Positive Breast Cancer
DOXOrubicin, Cyclophosphamide (AC 60/600) 21 day followed by weekly PACLitaxel (80) and weekly Trastuzumab Therapy (AC-TH)
Indication
00432a
Adjuvant Treatment of HER2 positive, High Risk Node Negative or Node Positive Breast Cancer.
00432b
Neoadjuvant Treatment of HER2 positive, High Risk Node Negative or Node Positive Breast Cancer.
Dose Dense DOXOrubicin, Cyclophosphamide (AC 60/600) 14 day followed by weekly PACLitaxel (80) and weekly Trastuzumab Therapy (DD AC-TH)
Indication
00433a
Adjuvant Treatment of HER2 positive, High Risk Node Negative or Node Positive Breast Cancer.
00433b
Neoadjuvant Treatment of HER2 positive, High Risk Node Negative or Node Positive Breast Cancer
Dose Dense DOXOrubicin, cycloPHOSphamide (AC 60/600) 14 day followed by PACLitaxel (175) 14 day and Trastuzumab Therapy(DD AC-TH)
Indication
00316a
Adjuvant Treatment of HER2 positive, High Risk Node Negative or Node Positive Breast Cancer.
00316b
Neoadjuvant Treatment of HER2 positive, High Risk Node Negative or Node Positive Breast Cancer.
epiRUBicin 90 and cycloPHOSphamide (EC90) Therapy
Exemestane Monotherapy
Indication
00376a
Adjuvant treatment of postmenopausal women with hormone receptor positive invasive early breast cancer.
00376b
Extended adjuvant treatment of hormone-dependent invasive breast cancer in postmenopausal women who have received prior adjuvant endocrine therapy.
5-Fluorouracil, epiRUBicin 100 and cycloPHOSphamide (FEC 100) Therapy
Indication
00265a
Neoadjuvant treatment for breast carcinoma
00265b
Adjuvant treatment for breast carcinoma
Gemcitabine (800mg/m2) Monotherapy - 28 Day
Indication
00749a
For the treatment of advanced breast cancer following two or more lines of therapy
Letrozole Monotherapy
Indication
00371a
Adjuvant treatment of postmenopausal women with hormone receptor positive invasive early breast cancer.
00371b
Extended adjuvant treatment of hormone-dependent-invasive breast cancer in postmenopausal women who have received prior adjuvant endocrine therapy for 5 years.
00371d
Neo-adjuvant treatment of postmenopausal women with hormone receptor positive breast cancer.
00371e
First-line treatment in postmenopausal women with hormone dependent advanced breast cancer.
Neratinib Therapy
Indication
00720a
Extended adjuvant treatment of adults with early-stage hormone receptor-positive, HER2-overexpressed/amplified breast cancer and who completed adjuvant trastuzumab-based therapy less than one year ago.
Olaparib (Tablet) Monotherapy
Indication
00588h
As monotherapy or in combination with endocrine therapy for the adjuvant treatment of adult patients with germline BRCA1/2-mutations who have HER2-negative high risk early breast cancer previously treated with neoadjuvant or adjuvant chemotherapy.
PACLitaxel (80) and Trastuzumab Therapy - 7 day (12 weeks)
Indication
00512a
Adjuvant Treatment of HER2 positive, Node-Negative Breast Cancer of tumor size ≤3cm
Pertuzumab/Trastuzumab (Phesgo®), PACLitaxel and CARBOplatin Therapy (TRAIN-2)
Indication
00790a
Neoadjuvant treatment of adult patients with HER2-positive, locally advanced, inflammatory, or early stage breast cancer at high risk of recurrence.
DOCEtaxel, CARBOplatin and Pertuzumab/Trastuzumab (Phesgo®) (TCHP) Therapy
Indication
00789a
Neoadjuvant treatment of adult patients with HER2-positive locally advanced, inflammatory or early breast cancer at high risk of recurrence.
DOCEtaxel, CARBOplatin, Trastuzumab and Pertuzumab (TCHP) Therapy
Indication
00722a
Neoadjuvant treatment of adult patients with HER2- positive locally advanced, inflammatory or early breast cancer at high risk of recurrence
DOCEtaxel, CARBOplatin, Trastuzumab (S/C) and Pertuzumab (TCH(S/C)P) Therapy
Indication
00731a
Neoadjuvant treatment of adult patients with HER2- positive locally advanced, inflammatory or early breast cancer at high risk of recurrence
Pembrolizumab 400mg, CARBOplatin AUC 5 and weekly PACLitaxel 80mg/m2 followed by Dose Dense DOXOrubicin and cycloPHOSphamide (AC 60/600) Therapy
Indication
00860a
Pembrolizumab in combination with chemotherapy as neoadjuvant treatment, and then continued as monotherapy as adjuvant treatment after surgery, is indicated for the treatment of adults with locally advanced, or early stage triple negative breast cancer at high risk of recurrence.
Pembrolizumab 400mg, Weekly CARBOplatin AUC 1.5 and PACLitaxel 80mg/m2 followed by Dose Dense DOXOrubicin and cycloPHOSphamide (AC 60/600) Therapy
Indication
00861a
Pembrolizumab in combination with chemotherapy as neoadjuvant treatment, and then continued as monotherapy as adjuvant treatment after surgery, is indicated for the treatment of adults with locally advanced, or early stage triple negative breast cancer at high risk of recurrence.
Pembrolizumab , CARBOplatin AUC 5 and weekly PACLitaxel 80mg/m2 followed by DOXOrubicin and cycloPHOSphamide (AC 60/600) Therapy
Indication
00857a
Pembrolizumab in combination with chemotherapy as neoadjuvant treatment, and then continued as monotherapy as adjuvant treatment after surgery, is indicated for the treatment of adults with locally advanced, or early stage triple negative breast cancer at high risk of recurrence.
Pembrolizumab , weekly CARBOplatin AUC 1.5 and PACLitaxel 80mg/m2 followed by DOXOrubicin and cycloPHOSphamide (AC 60/600) Therapy
Indication
00858a
Pembrolizumab in combination with chemotherapy as neoadjuvant treatment, and then continued as monotherapy as adjuvant treatment after surgery, is indicated for the treatment of adults with locally advanced, or early stage triple negative breast cancer at high risk of recurrence.
Pertuzumab, Trastuzumab, PACLItaxel and CARBOplatin Therapy (TRAIN-2)
Indication
00775a
Neoadjuvant treatment of adult patients with HER2-positive, locally advanced, inflammatory, or early stage breast cancer at high risk of recurrence.
Pertuzumab and Trastuzumab and chemotherapy -21 day cycle
Indication
00350a
Pertuzumab in combination with trastuzumab and chemotherapy for the neoadjuvant treatment of adult patients with HER2-positive, locally advanced, inflammatory, or early stage breast cancer at high risk of recurrence
00350b
Pertuzumab in combination with trastuzumab and chemotherapy for the adjuvant treatment of adult patients with HER2-positive breast cancer at high risk of recurrence
Ribociclib Therapy (Adjuvant) - 28 day
Indication
00892a
In combination with an aromatase inhibitor (AI) is indicated for the adjuvant treatment of patients with hormone receptor positive (HR+), human epidermal growth factor receptor 2 (HER2)-negative early breast cancer at high risk of recurrence.
Tamoxifen Monotherapy
Indication
00253a
Adjuvant treatment of oestrogen receptor positive breast cancer in pre- or post-menopausal women.
Trastuzumab (IV) Monotherapy - 21 days
Trastuzumab Subcutaneous 21 days - Early Breast Cancer
Indication
00285a
Following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable)
00285b
Following adjuvant chemotherapy with doxorubicin and cyclophosphamide, in combination with paclitaxel or docetaxel
00285c
In combination with adjuvant chemotherapy consisting of docetaxel and carboplatin.
00285d
In combination with neoadjuvant chemotherapy followed by adjuvant trastuzumab therapy, for locally advanced (including inflammatory) disease or tumours > 2 cm in diameter
Trastuzumab Emtansine (Kadcyla®) Early Breast Cancer Therapy- 21 days
Indication
00659a
As a single agent, is indicated for the adjuvant treatment of adult patients with HER2-positive early breast cancer who have residual invasive disease, in the breast and/or lymph nodes, after neoadjuvant taxane-based and HER2-targeted therapy
Zoledronic Acid Monotherapy
Indication
00545a
Adjuvant treatment of breast cancer in endocrine depleted pre- or post menopausal women