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Cisplatin + melphalan is a combination chemotherapy regimen consisting of two small molecule alkylating agents, each with distinct mechanisms of action. Cisplatin is a platinum-based compound that forms DNA crosslinks, leading to apoptosis in rapidly dividing cancer cells. Melphalan is a nitrogen mustard derivative that alkylates and crosslinks DNA and RNA, inhibiting replication and transcription. This combination has been used in high-dose regimens for the treatment of various cancers, including multiple myeloma, ovarian carcinoma, breast cancer, melanoma, sarcoma, and as part of conditioning protocols before hematopoietic stem cell transplantation. The rationale for combining these agents lies in their complementary mechanisms targeting DNA integrity through different chemical pathways[1][2][3].
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