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What Is TCHP Chemo and Is It Right for Me?

Navigating Treatment

January 25, 2024

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Fly View Productions/Getty Images

Fly View Productions/Getty Images

by Nandini Maharaj


Medically Reviewed by:

Teresa Hagan Thomas PHD, BA, RN


by Nandini Maharaj


Medically Reviewed by:

Teresa Hagan Thomas PHD, BA, RN


TCHP chemo involves taking four medications in order, administered by an IV drip. It may be best for people with HER2+ breast cancer. This chemo is associated with low rates of hospitalization and high rates of success.

Different types of chemotherapy drugs exist that can be taken alone or in combination with other drugs or treatments.

If you’ve been diagnosed with early stage breast cancer, your treatment team may recommend TCHP chemotherapy to shrink the tumor or prevent cancer cells from growing.

Here’s what you need to know about TCHP chemotherapy, including its effectiveness and side effects.

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What is TCHP chemo?

When chemotherapy is used to prepare for another treatment, like surgery, it’s called neoadjuvant therapy. With neoadjuvant therapy, the goal is to make the main treatment more likely to be successful.

According to a 2022 study, TCHP is a neoadjuvant therapy designed to help treat early stage breast cancer and locally advanced HER2-positive breast cancer.

A doctor may use TCHP treatment to shrink a tumor before operating on it. They may also recommend you stay on this treatment following surgery to kill any remaining cancer cells.

TCHP consists of four medications taken in a special order to treat cancer:

These drugs are given intravenously every 3 weeks for up to six cycles. Following this 18-week course of TCHP, you may continue with Herceptin with or without pertuzumab every 3 weeks for one year.

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How is TCHP chemo different from other types of chemo?

Researchers use pathologic complete response (pCR) to determine the effectiveness of a particular type of chemotherapy. A pCR refers to the absence of cancer in a tissue sample after receiving neoadjuvant chemotherapy.

Achieving pCR is associated with improved survival following treatment.

Results from a 2022 study found that TCHP had a pCR rate between 71% and 80% in HER2+ tumors.

A small 2018 study suggests that the pCR rate is higher with pertuzumab-based regimens. It also notes that TCHP regimens were associated with high tolerability:

  • 89% of participants received the intended doses
  • 16% had a dose delay due to toxicities
  • only 11% required hospitalization

In rare instances, TCHP treatment may affect heart function, which requires testing and monitoring. However, the same study mentioned above found that TCHP has low rates of cardiac toxicities (aka damage to the heart muscle caused by toxins).

How long does it take to recover from TCHP chemo?

Generally, the schedule for TCHP chemo is every 3 weeks with the first infusion occurring on day one.

The recovery period lasts 3 weeks from the time of the first infusion. Some improvement in side effects is often seen around week 2 or 3.

Depending on your bloodwork, you may need to pause between cycles. The 3-week cycle can be repeated up to 6 times, with the total treatment lasting 5–6 months.

The first TCHP infusion is administered by a doctor or nurse using an IV drip. It can take 5–7 hours depending on the wait time at the clinic, the person giving the infusion, and how well you tolerate the medications.

Side effects — including onset, duration, and intensity — will be different from person to person. Your treatment team may give you anti-nausea or antihistamine medications before the infusion to help make you more comfortable.

Side effects may include:

If you experience allergic reaction symptoms, such as runny nose, rashes, or difficulty breathing, make sure to report them to your nurse or doctor immediately.

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Is TCHP chemo right for me?

Remember to discuss your questions and concerns with your cancer care team so you can make informed decisions. The choice of chemotherapy drugs, doses, and schedules depends on the type and stage of cancer.

Having someone attend appointments with you or taking notes can help you remember what was discussed. It’s also a good idea to come prepared with questions to ask your doctor.

Some questions you may want to ask include:

  • What treatment options are available?
  • What tests do I need to figure out which type of chemo is right for me?
  • What’s your experience with treating this type of cancer?
  • What side effects can I expect, and how can I reduce them?
  • How will treatment affect my daily activities? Can I still work?
  • Will I lose my hair? If so, what can I do about it?
  • Will treatment affect my ability to have children or breastfeed (If applicable)?
  • Are there resources to help with child care or transportation?

Tips to recover from TCHP chemotherapy

Tips for recovering from TCHP chemotherapy are similar to those for other kinds of chemotherapy. These include the basics like getting lots of rest, staying hydrated, and doing gentle stretches or movements.

When it comes to eating, it may be easier for the body to eat small meals throughout the day and to stick to bland foods, soups, and smoothies.

You may have mouth irritation as a result of TCHP chemotherapy, but it’s important to maintain your dental care routine. Chewing sugar-free gum may help prevent undesirable side effects in the mouth.

If taking anti-nausea medication, do so as directed by a doctor.

It’s also vital to find a support system during treatment. This can include family, friends, group therapy, online communities, and more.

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Frequently asked questions

Want to learn more about TCHP chemo and related topics? Read on for the facts.

What is the survival rate for HER2-positive breast cancer?

More than 90% of people live 5 years beyond their diagnosis compared to people without cancer, according to the National Cancer Institute.

When the cancer hasn’t spread to other parts of the body, HER2-positive breast cancer has a 5-year relative survival rate of 98.8%.

What are the hardest days after chemo?

Usually, the day after the infusion is when major side effects occur, like nausea and fatigue. People tend to see the most improvement in side effects around week two or three.

Some people find hair loss especially difficult, which tends to occur around the second infusion.

What is the success rate of TCHP chemo?

TCHP has a success rate, or pCR, of 64%, as well as a 90% 3-year disease-free survival rate. Because of the pCR rate, the TCHP regimen is frequently used for HER2-positive breast cancer as a precursor to other treatments.

Is TCHP chemo harder on the body than other types of chemo?

Not everyone has the same side effects from TCHP chemo. Some people find the first few days after chemo to be the hardest on the body.

There are stronger chemo drugs for treating breast cancer, like doxorubicin, that may have more severe side effects.


TCHP is a combination chemotherapy regimen used to treat early stage breast cancer. Side effects include hair loss, nausea, and fatigue.

Speaking with your cancer care team can help you make informed treatment decisions.

Medically reviewed on January 25, 2024

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About the author

Nandini Maharaj

Nandini Maharaj, PhD is a freelance writer covering health, work, identity, and relationships. She holds a master’s degree in counseling and a PhD in public health. She’s committed to providing thoughtful analysis and engaging wellness content. Her work has appeared in HuffPost, American Kennel Club, Animal Wellness, Introvert, Dear, and POPSUGAR. She is a dog mom to Dally, Rusty, and Frankie. Find her on Twitter or her website.

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