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This is a four-drug combination chemotherapy regimen known as MACC, consisting of doxorubicin hydrochloride (Adriamycin), cyclophosphamide, lomustine (CCNU), and methotrexate. The regimen has been primarily studied in advanced lung cancers such as bronchogenic carcinoma and non-small cell lung cancer (NSCLC). Each component acts via a distinct mechanism to inhibit cancer cell proliferation: - Doxorubicin (Adriamycin) is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II. - Cyclophosphamide is an alkylating agent that crosslinks DNA strands. - Lomustine is a nitrosourea alkylating agent causing DNA damage. - Methotrexate inhibits dihydrofolate reductase, blocking folic acid metabolism required for DNA synthesis. The combination aims to maximize antitumor activity by targeting different pathways involved in cell division. Clinical studies have shown moderate response rates with manageable toxicity profiles in advanced lung cancer patients[1][2][4].
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