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This combination consists of three cytotoxic chemotherapy agents—cyclophosphamide, methotrexate, and fluorouracil—plus pegfilgrastim. Cyclophosphamide is an alkylating agent that inhibits cancer cell replication by cross-linking DNA strands. Methotrexate and fluorouracil are antimetabolites that disrupt DNA synthesis and repair by mimicking natural cellular metabolites; this leads to cell death during division. Pegfilgrastim is a long-acting granulocyte colony-stimulating factor analog used to reduce the risk of neutropenia by stimulating the production of neutrophils via activation of the granulocyte colony-stimulating factor receptor on myeloid cells. The combination is primarily used in early-stage breast cancer but may also be applied in other cancers such as metastatic prostatic carcinoma or as part of other regimens where myelosuppression risk warrants prophylactic use of pegfilgrastim[1][3][4][6].
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