CCNU + cisplatin + cytosine arabinoside + hydroxyurea + dacarbazine + methylprednisolone + procarbazine + vincristine

This is a multi-agent chemotherapy regimen composed of eight drugs: lomustine (CCNU), cisplatin, cytosine arabinoside (also known as cytarabine), hydroxyurea, dacarbazine, methylprednisolone, procarbazine, and vincristine. Each component has a distinct mechanism of action targeting cancer cells through various pathways: - Lomustine (CCNU) is an alkylating agent that damages DNA to prevent cancer cell replication[1][2][3]. - Cisplatin forms DNA crosslinks leading to apoptosis. - Cytosine arabinoside inhibits DNA synthesis by acting as an antimetabolite. - Hydroxyurea inhibits ribonucleotide reductase, blocking DNA synthesis. - Dacarbazine acts as an alkylating agent causing DNA damage. - Methylprednisolone is a corticosteroid with anti-inflammatory and immunosuppressive effects; in oncology it can induce apoptosis in certain lymphoid cells. - Procarbazine is also an alkylating agent that disrupts DNA and RNA synthesis[7]. - Vincristine binds tubulin and inhibits microtubule formation during mitosis. This combination would be used for aggressive or refractory cancers where multi-modal attack on tumor biology is required. Such regimens are typically reserved for high-grade brain tumors or hematologic malignancies when standard therapies have failed or in clinical trials.