TCHP is a type of combination chemotherapy that treats early-stage breast cancer. It consists of four medications that doctors administer intravenously. These drugs help to kill or slow the growth of cancer. However, they may also cause side effects such as nausea, fatigue, and hair loss.

Chemotherapy is a cancer treatment that uses drugs that kill cancer cells. This can help prevent the cancer cells from growing and producing more cells. Breast cancer is the second leading cause of cancer death among females.

Chemotherapy for breast cancer can be a useful treatment to help slow the growth of cancer, shrink tumors, and improve health outcomes.

In this article, we will discuss the TCHP chemotherapy regimen, including its effectiveness and possible side effects.

A person receiving chemotherapy.Share on Pinterest
FatCamera/Getty Images

TCHP is a four-drug neoadjuvant cancer therapy to help treat early-stage HER2-positive breast cancer.

The term neoadjuvant means that a person typically receives this treatment to shrink a tumor before surgery. However, people may continue receiving TCHP after surgery to help eliminate any remaining cancer cells.

It is a combination drug therapy, meaning that a person receives more than one type of drug at a time. THCP chemotherapy includes:

  • docetaxel (Taxotere)
  • carboplatin (Paraplatin)
  • trastuzumab (Herceptin)
  • pertuzumab (Perjeta)


Docetaxel is a chemotherapy drug that destroys cancerous cells. People take it intravenously, as a drip.

Docetaxel treatment sessions usually take roughly an hour. Physicians administer it once every 3 weeks.


As well as helping with breast cancer treatment, a doctor may also recommend carboplatin to treat ovarian and lung cancers.

Carboplatin treatment takes about an hour, and people typically receive it in 3- or 4-week periods, depending on the type of cancer. Sources also note that it is the only platinum-based chemotherapy with Food and Drug Administration (FDA) approval to treat breast cancer.


Trastuzumab is a monoclonal antibody that locks onto the HER2 protein. High levels of HER2 can be present in some cancers, including certain types of breast cancers. These are known as HER2-positive cancers.

Timings and frequency of trastzumab vary depending on the type of cancer. For breast cancer, treatment may last between 30–90 minutes, and a person may have it every week or every 3 weeks and may continue using it after the regimen.

Learn more about trastuzumab here.


Pertuzumab is another monoclonal antibody that also targets the HER2 protein. A doctor may recommend both pertuzumab and trastuzumab if a person has a higher risk of recurrent breast cancer or metastases in the lymph nodes.

Similar to the other drugs in the THCP regimen, pertuzumab treatment can take up to an hour, and a person receives it every 3 weeks.

A person will repeat the TCHP treatment cycle every 21 days, or 3 weeks. A person will likely have 6 cycles and a doctor will discuss if a person requires further treatment after completing the regimen.

Often, a person may continue treatment with trastuzumab for up to a year. The schedule may run as below:

DayDrug treatmentAdministrationDuration



Intravenously, by drip into a veinApproximately 5 hours for the first treatment; if no reactions, later treatments may be 4 hours

Before or on the day of treatment, a healthcare professional may need to perform tests, such as blood tests, echocardiogram, or electrocardiogram (ECG), to ensure the person is a suitable candidate for the THCP regimen. Often, a person will also receive antiemetic drugs before starting chemotherapy.

THCP therapy can be a useful treatment for HER2-positive breast cancer. A pathologic complete response (pCR) describes when there is no sign of cancer in a tissue sample after treatment such as chemotherapy.

Researchers can use a pCR to demonstrate if treatment is working. Some evidence notes that the THCP combination has a (pCR) rate of 66.2%.

A 2021 study found that adding pertuzumab to standard chemotherapy treatment is beneficial for those with HER2-positive breast cancer. A 2022 study found similar results for treating metastatic breast cancer and also notes that treatment with pertuzumab does not increase the risk of heart problems.

In general, some side effects of four-drug TCHP treatment may include:

  • hair loss
  • fatigue
  • diarrhea
  • muscle aches
  • numbness
  • heartburn
  • nausea

Some people may also experience:

  • constipation
  • vomiting
  • fever
  • swelling of the arms and legs

Rarely, it may also cause:

  • kidney damage
  • lung inflammation
  • leukemia
  • heart problems


For example, docetaxel injectable treatment can cause:

  • taste changes
  • shortness of breath
  • neuropathy
  • infections due to low white blood cell count


The following are some common side effects that come with carboplatin:

  • anemia
  • nausea and vomiting
  • nerve damage in the hands, arms, feet, and legs
  • hair loss


Trastuzumab may cause:

  • fever
  • nausea and vomiting
  • coughing
  • shortness of breath


Common side effects of pertuzumab may include:

  • hair loss
  • diarrhea
  • loss of appetite
  • rash

TCHP is a combination drug treatment that includes docetaxel, carboplatin, trastuzumab, and pertuzumab. These are drugs that people take intravenously to kill cancer cells if they have early-stage HER2+ breast cancer.

Evidence suggests this treatment is beneficial for this type of breast cancer. As with most chemotherapy treatments, a person may experience side effects when receiving the THCP regimen.