carboplatin + gemcitabine + thalidomide

This is a combination chemotherapy regimen consisting of three agents: - **Carboplatin** is an organoplatinum alkylating agent that forms DNA crosslinks, inhibiting DNA synthesis and function, leading to apoptosis in rapidly dividing cells. - **Gemcitabine** is a nucleoside analog (cytidine analog) that inhibits DNA synthesis by incorporation into DNA and inhibition of ribonucleotide reductase, resulting in cell cycle arrest and apoptosis. - **Thalidomide** is an immunomodulatory drug with antiangiogenic properties; it inhibits the growth of new blood vessels required for tumor growth and modulates immune responses. This combination has been investigated primarily for the treatment of non-small cell lung cancer (NSCLC), including as neoadjuvant therapy for locally advanced or inoperable disease. Clinical trials have shown that while the regimen can be effective in downstaging tumors pre-surgery, adding thalidomide to carboplatin/gemcitabine does not improve overall survival but increases thrombotic risk. Thalidomide’s antiangiogenic effect may enhance cytotoxicity when combined with standard chemotherapy[1][2][4][8].