cyclophosphamide + doxorubicin + fluorouracil + thiotepa

This is a combination chemotherapy regimen consisting of four cytotoxic agents: cyclophosphamide, doxorubicin, fluorouracil (5-FU), and thiotepa. 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. Doxorubicin is an anthracycline antibiotic that intercalates into DNA and inhibits topoisomerase II, preventing DNA replication and repair. Fluorouracil is an antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis. Thiotepa is another alkylating agent causing crosslinking of DNA strands. This combination has been studied primarily in the treatment of high-risk or metastatic breast cancer as part of induction or consolidation regimens[1][3][6]. The regimen aims to maximize tumor cell kill by combining drugs with different mechanisms and non-overlapping toxicities.