5-fluorouracil + epirubicin + cyclophosphamide + docetaxel + zoledronic acid

This is a multi-agent chemotherapy and supportive care regimen composed of five drugs: - **5-fluorouracil** (a pyrimidine analog antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis) - **Epirubicin** (an anthracycline antibiotic that intercalates into DNA and inhibits topoisomerase II, leading to DNA strand breaks) - **Cyclophosphamide** (an alkylating agent that crosslinks DNA strands, preventing cell division) - **Docetaxel** (a taxane that stabilizes microtubules and prevents their depolymerization, inhibiting mitosis) - **Zoledronic acid** (a bisphosphonate that inhibits osteoclast-mediated bone resorption and has demonstrated anti-tumor effects including inhibition of tumor cell proliferation, induction of apoptosis, inhibition of angiogenesis, reduction in tumor cell adhesion/invasion/migration in bone tissue) This combination is not a standard named regimen but represents an intensive approach for the treatment or prevention of metastatic breast cancer involving both cytotoxic chemotherapy agents and bone-targeted therapy. The primary indications are advanced or high-risk breast cancer with risk or evidence of bone metastases. Zoledronic acid is included to reduce the risk of skeletal-related events and may also have direct anti-tumor activity[1][2][6][7].