cyclophosphamide + goserelin + leuprorelin

This is a combination regimen consisting of three drugs: - **Cyclophosphamide** is an alkylating agent used as chemotherapy, primarily for its cytotoxic effects on rapidly dividing cells. It crosslinks DNA, leading to cell death. - **Goserelin** and **leuprorelin (leuprolide)** are both gonadotropin-releasing hormone (GnRH) agonists. They act by initially stimulating, then downregulating the pituitary GnRH receptors, resulting in decreased secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This leads to suppression of ovarian or testicular steroidogenesis and a reduction in circulating estrogen or testosterone levels. The combination of these agents may be used in clinical settings where both cytotoxic chemotherapy and profound hormonal suppression are desired—such as certain breast cancers in premenopausal women for ovarian protection during chemotherapy or advanced hormone-sensitive cancers[3][6][9]. Goserelin and leuprorelin have been shown to be comparable for ovarian protection during cyclophosphamide-based chemotherapy[3].