cisplatin + filgrastim + ifosfamide + vinorelbine

This is a multi-agent chemotherapy regimen composed of four drugs: - **Cisplatin** is a platinum-based chemotherapeutic that forms DNA crosslinks, leading to apoptosis in rapidly dividing cells. - **Filgrastim** is a recombinant human granulocyte colony-stimulating factor (G-CSF) that stimulates the production of neutrophils and is used to reduce the risk of infection due to neutropenia from chemotherapy. - **Ifosfamide** is an alkylating agent that interferes with DNA replication and transcription, leading to cell death. - **Vinorelbine** is a semi-synthetic vinca alkaloid that inhibits microtubule assembly, arresting cell division at metaphase. This combination targets cancer cells through multiple mechanisms—DNA damage, inhibition of mitosis, and support for white blood cell recovery. Regimens containing subsets of these agents (notably cisplatin/ifosfamide/vinorelbine or ifosfamide/vinorelbine with G-CSF support) have been studied in relapsed/refractory Hodgkin lymphoma and advanced non-small cell lung cancer[1][2][3][4]. The addition of filgrastim helps mitigate chemotherapy-induced neutropenia.