TC Protocol: Taxotere + Cytoxan

If you’ve been diagnosed with breast cancer that hasn’t spread to other parts of your body, your doctor may recommend that you receive TC chemotherapy. , 

TC chemo is a combination of two chemotherapy medicines, given over several months. The TC protocol includes:

• Sponsor Message

  Taxotere (chemical name: docetaxel) 

• Sponsor Message

  Cytoxan (chemical name: cyclophosphamide) 

Your recommended chemo regimen will be based on the type of breast cancer you have. The type and stage of cancer will also influence whether it will be given before or after surgery.

The TC protocol is one of many chemotherapy treatment options for people with breast cancer that hasn’t spread to other parts of the body, especially if the cancer is triple-negative. 

In clinical trials comparing AC to TC chemo, TC was shown to be slightly more effective. And since TC doesn’t include an anthracycline, it may be a good option for people with heart problems.

The two medications in the TC regimen work in different ways.

Taxotere is a taxane, which interferes with the ability of cancer cells to divide by attacking the internal structure that supports the cell.  

Cytoxan is an alkylating agent, which stops breast cancer cells from reproducing by damaging the DNA inside the cells. As a result, their growth is significantly reduced (or even stopped altogether). 

The TC protocol is typically given once every three weeks. On chemo days, you’ll receive an infusion of Taxotere and Cytoxan  (either into a vein in your arm, hand, or through a port or line). Then, you’ll rest for 20 days before your next chemo day. Typically, TC is given four to six times over twelve to eighteen weeks.

While on TC, you may experience any of the common side effects of Taxotere or Cytoxan, including:

• Sponsor Message

  low white blood cell count

• Sponsor Message

  hair loss

• Sponsor Message

  nausea

• Sponsor Message

  vomiting

• Sponsor Message

  loss of appetite

• Sponsor Message

  constipation

• Sponsor Message

  diarrhea

• Sponsor Message

  irregular periods — this can include temporary cessation (usually resume after medication is completed) or permanent cessation of menstrual periods depending on your age and other factors

• Sponsor Message

  increased risk of infection

• Sponsor Message

  fluid retention

• Sponsor Message

  allergic reactions

• Sponsor Message

  numbness in the fingers and toes (neuropathy)

• Sponsor Message

  taste changes

• Sponsor Message

  fatigue

• Sponsor Message

  muscle pain

• Sponsor Message

  bone or joint pain

• Sponsor Message

  nail changes

• Sponsor Message

  mouth or throat sores

• Sponsor Message

  watery eyes

TC is not safe during pregnancy, as each medication has the potential to cause fetal harm. It’s also not recommended if you’re breastfeeding — the drugs can be passed through breast milk. If you plan on getting pregnant in the future, talk to your doctor about fertility preservation before starting the TC regimen.

Members of our community discuss their experiences with TC chemotherapy in the community forum. Here are some of their comments. Remember, it's very important to talk to your doctor about any side effects you're having and ask about ways to manage them.

“I felt exhausted and had a low-grade fever from day 2-5ish after TC#2, but I feel fine now. My hands and feet, which I freeze the heck out of during chemo, are fine. My nails are normal, and no neuropathy. I didn't have any nausea with TC #2, but I did have constipation. My gastro doc wants me to start Miralax a day or two before chemo to help with that.” — OnTarget

“2 weeks out now from my first TC infusion and feel pretty good. Will see how it goes after next. On day 14 I think my hair is all there; I keep waiting for the falling out to start.” — aviva5675

“I’m on day 11 of TC#1. My hair looks the same, I worked all week, and I’m sticking to my 10-30 minutes of walking/biking a day (it calms my mind). My one-week blood work came back with elevated liver enzymes and low platelets so I go back next week and watch for symptoms. My weight did go up 7lbs in two days post chemo and it’s down 6 now; the MO says it’s water weight. My throat and mouth have been feeling sore/weird, but my energy levels are better.” — GreenOutdoors

Read more in our TC chemo discussion forum.

The cost of TC chemo treatment may vary. The price you’ll pay depends on your health insurance provider and plan, where you live, and the pharmacy you use.

Note: Your insurance company may require you to get prior authorization before covering TC. 

If you have trouble paying for TC, ask your pharmacist or care team about financial assistance programs that may be able to help.

Learn more about financial assistance and medicine cost-lowering tips.