Oncura

TCHP: what to expect, day by day

Breast - HER2+21-day cycle6 effects documented

Four medicines together every 3 weeks (no anthracycline). Diarrhea is the most common issue; your heart function is checked regularly because two of the drugs target HER2.

Docetaxel + carboplatin + trastuzumab + pertuzumab q3wk (anthracycline-free). Incidence from the FDA Perjeta label neoadjuvant TCH+P arm (n=76). Diarrhea and heart monitoring are the signature issues.

Timed to the cycle

Day 1 is the day of your infusion. These are the effects a retrievable document ties to a day range for this regimen — not a prediction about you.

Neutropenia

Typically around days 7–28

Low infection-fighting white cells, lowest about days 7-10.

Call your team urgently: A temperature of 100.4°F (38.0°C) or higher — an emergency.

reported by about 49% of people; severe in 46% · Timing from the manufacturer’s prescribing information · from Docetaxel, Carboplatin

Febrile neutropenia

Typically around days 7–28

A fever during the low-count window — common enough that a white-cell booster is often given.

Call your team urgently: Any fever of 100.4°F (38.0°C) or higher — call immediately.

reported by about 17% of people · Timing from the manufacturer’s prescribing information · from Docetaxel, Carboplatin

Hair loss

Typically around days 14–21

Common with the docetaxel component; grows back after chemo.

reported by about 55% of people · Timing from a drug-monograph reference · from Docetaxel

Not tied to a cycle day

These build with the number of doses, or are measured from when treatment started, so a cycle day would be the wrong shape for them. Each keeps the timing its own source states.

Diarrhea

often cycle 1, in the days after infusion

Loose or frequent stools — the most common effect, driven by pertuzumab, often starting in the first cycle.

Call your team: More than 4-6 stools a day above normal, or signs of dehydration.

reported by about 72% of people; severe in 12% · from Pertuzumab

Cardiotoxicity

checked by echo/MUGA every ~3 months during treatment

The HER2 drugs can temporarily weaken the heart's pumping. It's usually silent and picked up on scans, and typically recovers when treatment is paused. TCHP avoids anthracyclines partly to keep this risk lower.

Call your team: New shortness of breath, leg/ankle swelling, or a racing/irregular heartbeat.

reported by about 3.9% (asymptomatic LVEF decline) of people; severe in ~0% · from Trastuzumab, Pertuzumab

Fatigue

Tiredness that builds across cycles.

reported by about 42% of people; severe in 4% · from Docetaxel, Carboplatin, Trastuzumab, Pertuzumab

Where this comes from

1. S1. Pertuzumab (Perjeta) FDA prescribing information, Table 5 (neoadjuvant TCH+P, n=76) (2025) — FDA label 125409Orig1s137lbl
2. S2. Schneeweiss A, TRYPHAENA (Arm C = TCHP) (2013) — PMID 23704196

Timing windows on this page rest on:

• Taxotere (docetaxel) FDA prescribing information — “The median time to nadir was 7 days, while the median duration of severe neutropenia (<500 cells/mm3) was 7 days” source
• NCI PDQ — Fatigue (health professional) — “five distinct trajectories ... significant interindividual variability” source
• BC Cancer Drug Manual — paclitaxel — “usually complete, generally occurs 14-21 days after administration of paclitaxel; onset sudden, often occurring in a single day” source

A window appears here only where a retrievable document ties it to a drug in this regimen. Where nothing could be found, the window was removed rather than estimated — so a missing time is an honest gap, not an oversight.

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