astragalus polysaccharides + epirubicin + cyclophosphamide

This is a combination therapy consisting of astragalus polysaccharides (APS), epirubicin, and cyclophosphamide. Astragalus polysaccharides are bioactive components derived from the root of Astragalus membranaceus, widely used in traditional Chinese medicine. APS exhibits immunomodulatory and antitumor effects by stimulating immune cells, disrupting cancer cell cycles, inhibiting signal transduction pathways (such as PI3K/Akt/mTOR), activating autophagy, and reversing the immunosuppressive tumor microenvironment through mechanisms like PD-L1 inhibition and TLR4/MyD88 pathway regulation[1][2][4]. Epirubicin is an anthracycline chemotherapeutic agent that intercalates DNA strands and inhibits topoisomerase II activity, leading to apoptosis in rapidly dividing cells. Cyclophosphamide is an alkylating agent that crosslinks DNA strands to prevent cell division and induce apoptosis. The combination aims to enhance antitumor efficacy by leveraging both direct cytotoxicity (epirubicin/cyclophosphamide) and immune modulation (APS). APS has been shown in clinical studies to improve chemotherapy outcomes by enhancing immune function, reducing chemotherapy-induced toxicity such as leukopenia or fatigue, improving quality of life metrics for cancer patients, and potentially prolonging survival[1][3][4].