Oncura

AC-T (Dose Dense): what to expect, day by day

Breast14-day cycle5 effects documented

Given in two parts (AC, then T) every 2 weeks with a white-cell booster. Most effects are temporary; neuropathy and heart effects can be longer-lasting.

Dose-dense AC×4 q2wk (doxorubicin+cyclophosphamide) then paclitaxel q2wk, each with G-CSF support. Onset is nadir-based, in days since infusion.

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.

NeutropeniaPROVISIONAL

Typically around days 8–21

A temporary drop in infection-fighting white cells. Dose-dense scheduling uses a white-cell booster, which keeps severe drops lower than you'd expect.

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

severe in 6-15% · Timing from the manufacturer’s prescribing information · from Doxorubicin, Cyclophosphamide, Paclitaxel

Hair loss

Typically around days 14–21

Hair loss is near-universal with this regimen and grows back after treatment ends.

Call your team: Scalp pain, redness, or inflammation.

reported by about 100% of people · Timing from a drug-monograph reference · from Doxorubicin, Cyclophosphamide, Paclitaxel

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.

Nausea

Sickness in the first 24 hours is the "acute" phase and usually peaks 2-3 hours in; anything from 24 to 120 hours is the "delayed" phase.

The AC part is strongly nausea-causing; you'll get strong anti-nausea medicine to prevent it.

Call your team: Can't keep fluids down for more than 12 hours.

reported by about 70% of people; severe in 5-15% · Timing from a clinical guideline · from Doxorubicin, Cyclophosphamide

Neuropathy

Builds up with the number of doses rather than arriving on a particular day of the cycle. Tell your team early — adjusting the dose is what helps most.

Tingling or numbness in the hands and feet from the paclitaxel (T) part. It builds over the taxane doses and can linger.

Call your team: New or worsening numbness, or trouble with buttons/zippers.

reported by about 20% of people; severe in 3% · Timing from the manufacturer’s prescribing information · from Paclitaxel

Cardiotoxicity

Most heart effects that appear do so within the first year. They are checked by scan every few months during treatment, not by cycle day.

The anthracycline can affect the heart muscle. At this regimen's total dose the risk is low, and your team tracks heart function.

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

severe in <1% · Timing from a clinical guideline · from Doxorubicin

Where this comes from

1. S1. Citron ML, CALGB/Intergroup C9741 (dose-dense) (2003) — PMID 12668651
2. S2. Paclitaxel (Taxol) FDA prescribing information (adjuvant AC→paclitaxel) — FDA label
3. S3. Sparano JA, ECOG E1199 (2008) — PMID 18420499

Timing windows on this page rest on:

• Taxol (paclitaxel) FDA prescribing information — “Neutrophil nadirs occurred at a median of 11 days” source
• MASCC/ESMO antiemetic consensus — emesis phases — “acute 0-24 h, delayed 25-120 h, overall 0-120 h” 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
• American College of Cardiology — anthracycline cardiotoxicity (2024) — “acutely (<1% of cases), early-onset (within first year, 98% of cases), or late-onset (>1 year after treatment)” 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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