cisplatin + ifosfamide + mitomycin C + mustine

This is a high-dose combination chemotherapy regimen consisting of four cytotoxic agents: cisplatin, ifosfamide, mitomycin C, and mustine (also known as mechlorethamine). The regimen has been studied in advanced non-small cell lung cancer (NSCLC), particularly in patients with metastatic disease. Each component acts via a distinct mechanism to damage DNA and inhibit cancer cell proliferation. Cisplatin forms DNA crosslinks leading to apoptosis; ifosfamide is an alkylating agent causing DNA strand breaks; mitomycin C is an antitumor antibiotic that induces DNA crosslinking; and mustine is a nitrogen mustard alkylating agent that also crosslinks DNA. This combination was evaluated with autologous bone marrow support due to its myelosuppressive effects. In clinical studies, the regimen showed a high response rate but did not improve overall survival compared to conventional dosing of the same agents[1][2].