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FUMEP is a combination chemotherapy regimen consisting of cisplatin, etoposide (VP-16), fluorouracil (5-FU), leucovorin (citrovorum factor), and mitomycin. It has been investigated and utilized primarily as a salvage or consolidation therapy for advanced, recurrent, or aggressive malignancies, including inflammatory breast cancer (IBC) and multiple myeloma. The regimen combines multiple cytotoxic mechanisms to overcome drug resistance: cisplatin and mitomycin act as DNA alkylating and crosslinking agents; etoposide inhibits DNA topoisomerase II; and fluorouracil, whose activity is biochemically enhanced by leucovorin, acts as an antimetabolite inhibiting thymidylate synthase. This multi-agent approach aims to maximize tumor cell death but is associated with significant hematological and systemic toxicities.
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