cyclophosphamide + dactinomycin + doxorubicin + vincristine

This is a combination chemotherapy regimen consisting of four cytotoxic agents: cyclophosphamide, dactinomycin (also known as actinomycin D), doxorubicin (also known as Adriamycin), and vincristine. Each drug has a distinct mechanism of action targeting rapidly dividing cancer cells. Cyclophosphamide is an alkylating agent that crosslinks DNA, leading to cell death. Dactinomycin intercalates into DNA and inhibits RNA synthesis. Doxorubicin is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II, causing double-strand breaks in DNA. Vincristine binds to tubulin, inhibiting microtubule formation and arresting cell division at metaphase.

This combination is used primarily in pediatric oncology for the treatment of Wilms tumour and rhabdomyosarcoma, among other childhood cancers. The regimen may be adapted or intensified for high-risk or relapsed disease settings.