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This is a combination chemotherapy and supportive care regimen consisting of four agents: - **Cyclophosphamide** is an alkylating agent that interferes with DNA replication and transcription, leading to cell death. - **Docetaxel** is a taxane-class antineoplastic that stabilizes microtubules, inhibiting cell division. - **Epidoxorubicin (epirubicin)** is an anthracycline antibiotic that intercalates into DNA, inhibits topoisomerase II, and generates free radicals causing cytotoxicity. - **Pegfilgrastim** is a long-acting recombinant human granulocyte colony-stimulating factor (G-CSF) analogue used as supportive care to stimulate neutrophil production and reduce the risk of chemotherapy-induced neutropenia. This combination has been studied primarily in breast cancer regimens. The inclusion of pegfilgrastim aims to ameliorate the myelosuppressive effects—especially neutropenia—caused by the cytotoxic agents[1][6][7]. The regimen may be administered in alternating or sequential schedules depending on protocol design. Pegfilgrastim does not have direct antitumor activity but supports hematopoietic recovery during intensive chemotherapy cycles.
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