TCHP

Say it: tee-see-aitch-PEE

Docetaxel, carboplatin, trastuzumab and pertuzumab

TCHP combines two chemotherapy medicines with two HER2 targeted antibodies, and it is often given before surgery for HER2 positive breast cancer.

Also called: TCH plus pertuzumab, TCH, TCHP chemo, docetaxel carboplatin Herceptin Perjeta, TCH-Phesgo, TCHP with Phesgo

What it is

HER2 is a protein that drives some breast cancers to grow fast. Trastuzumab and pertuzumab block HER2 in two different ways, and the chemotherapy kills dividing cancer cells. Giving it before surgery can shrink the cancer and show how well it responds. The goal is cure.

Often used for

• HER2 positive early stage breast cancer before surgery
• HER2 positive breast cancer after surgery
• HER2 positive locally advanced breast cancer

With Phesgo (shot form)

Trastuzumab and pertuzumab can be given together as one shot under the skin of the thigh, which takes minutes instead of hours.

HER2 therapy after surgery

After surgery, trastuzumab with or without pertuzumab continues to finish about 1 year. If cancer is still found at surgery, your team may switch to a different HER2 medicine (trastuzumab emtansine).

The medicines in this plan

Docetaxel

Taxane chemotherapy. Given through a vein over about 1 hour on day 1.

Carboplatin

Platinum chemotherapy. Given through a vein over 30 to 60 minutes on day 1.

Trastuzumab

Antibody that blocks HER2. Given through a vein (or as a shot) on day 1; the first dose takes longer.

Pertuzumab

Antibody that blocks HER2 in a different spot than trastuzumab. Given through a vein on day 1.

How you get it

TCHP is given in an outpatient infusion clinic every 21 days for 6 cycles (about 4 months). The first day can take 5 to 6 hours because the first antibody doses go in slowly; later days are shorter. Many people have a port. The HER2 antibodies usually continue after chemotherapy ends to complete about 1 year. Your schedule may be different.

A typical cycle

Day before

Start dexamethasone pills to prevent reactions and fluid buildup from docetaxel.

Day 1

Blood tests, then pertuzumab, trastuzumab, docetaxel and carboplatin through a vein. You are watched after the antibodies for reactions.

Day 2

White blood cell booster shot (or on-body injector) in many cases.

Days 3 to 10

Diarrhea, tiredness and nausea are most likely. Blood counts are lowest around days 7 to 12.

Days 11 to 21

Recovery. Visit and blood tests before the next cycle.

Common side effects and what helps

• Diarrhea, which is very common with pertuzumab. Keep loperamide at home and drink lots of fluids.
• Tiredness. Gentle walking helps.
• Low blood counts, including low platelets and anemia from carboplatin. Wash hands often and watch for bruising.
• Hair loss. Ask about scalp cooling.
• Nausea and taste changes. Take anti-nausea medicine on schedule and try bland, cool foods.
• Mouth sores. Rinse with a mild salt and baking soda rinse and use a soft toothbrush.
• Nail changes and dry skin or rash. Moisturize daily and keep nails short.
• Tingling in fingers and toes, and swelling from fluid. Tell your team if these get worse.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Diarrhea 4 or more times a day above normal, or diarrhea with dizziness or weakness
• Shortness of breath, swelling of the legs, or a racing or pounding heartbeat
• Chills, rash, wheezing or face swelling during or after the infusion
• Unusual bleeding or bruising
• Vomiting or you cannot keep fluids down

Good to know

• Trastuzumab and pertuzumab can weaken the heart muscle. You will have a heart ultrasound (echocardiogram) or MUGA scan before starting and about every 3 months.
• Blood counts and kidney function are checked before each cycle.
• Trastuzumab and pertuzumab can harm an unborn baby. Use reliable birth control during treatment and for 7 months after the last dose.
• Take every dexamethasone dose as prescribed to lower allergy and swelling risk from docetaxel.
• Ask about fertility preservation before starting if you may want children.

At home

• Keep loperamide at home and start it at the first loose stool, as your team instructs.
• Drink 8 to 10 cups of fluid a day, more if you have diarrhea.
• Keep a thermometer handy and check if you feel unwell.
• Use alarms for your dexamethasone days.
• Avoid crowds and sick people during low count days.

Questions to ask

• Will I have surgery after TCHP, and when?
• Can I get the shot form (Phesgo) instead of IV antibodies?
• How often will my heart be checked?
• What happens after surgery, and how long will HER2 therapy last?
• Can I use scalp cooling?

Breast cancer

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.