anlotinib + cyclophosphamide + docetaxel + epirubicin

Anlotinib + cyclophosphamide + docetaxel + epirubicin is a multi-agent combination regimen used primarily in the neoadjuvant treatment of cancers such as triple-negative breast cancer (TNBC) and investigated in other solid tumors. Anlotinib is a novel oral small molecule tyrosine kinase inhibitor that targets multiple receptor tyrosine kinases involved in tumor angiogenesis and growth, including vascular endothelial growth factor receptors (VEGFR1/2/3), platelet-derived growth factor receptor (PDGFRα/β), fibroblast growth factor receptor (FGFR1–4), c-Kit, and others. Cyclophosphamide is an alkylating agent that crosslinks DNA, leading to cell death. Docetaxel is a taxane-class chemotherapeutic that stabilizes microtubules and inhibits cell division. Epirubicin is an anthracycline antibiotic that intercalates into DNA and inhibits topoisomerase II, preventing DNA replication. This combination leverages the anti-angiogenic effects of anlotinib with the cytotoxic actions of standard chemotherapies to enhance tumor response rates. Clinical studies have shown promising efficacy with manageable toxicity profiles for this regimen in locally advanced TNBC[7][8]. The combination has demonstrated higher pathologic complete response rates compared to chemotherapy alone[7].