cisplatin + doxorubicin + ifosfamide + vincristine

A combination chemotherapy regimen consisting of cisplatin, doxorubicin, ifosfamide, and vincristine. This multi-agent regimen combines different mechanisms of action including DNA cross-linking, topoisomerase II inhibition, and microtubule disruption. It has been used in the treatment of sarcomas, particularly Ewing's sarcoma, and requires supportive care including mesna, antiemetics, and hematopoietic growth factors. The drugs in this combination work through different mechanisms: - **Cisplatin**: A platinum-based compound that cross-links DNA, interfering with cell division - **Doxorubicin**: An anthracycline that intercalates DNA and inhibits topoisomerase II - **Ifosfamide**: An alkylating agent that cross-links DNA strands - **Vincristine**: A vinca alkaloid that binds to tubulin and disrupts microtubule formation