carboplatin + cyclophosphamide + melphalan

This is a combination chemotherapy regimen consisting of three alkylating agents—carboplatin, cyclophosphamide, and melphalan. Each drug interferes with DNA replication and transcription by forming cross-links in DNA strands, leading to cell death. This combination has been studied primarily in the context of high-dose chemotherapy for metastatic breast cancer, often as part of an intensification protocol with autologous stem cell or bone marrow support. The rationale for combining these agents is to exploit their synergistic cytotoxic effects while targeting cancer cells through different mechanisms within the alkylating agent class[1][3]. Carboplatin forms platinum-DNA adducts; cyclophosphamide is metabolized into active compounds that cross-link DNA; melphalan directly alkylates and cross-link DNA bases.