cyclophosphamide + dexrazoxane + epirubicin

This is a combination chemotherapy regimen consisting of three agents: - **Cyclophosphamide** is an alkylating agent that interferes with DNA replication and transcription, leading to cell death. It is widely used in the treatment of various cancers, including breast cancer. - **Epirubicin** is an anthracycline antibiotic that intercalates into DNA, inhibiting topoisomerase II and generating free radicals, resulting in cytotoxicity. It is commonly used for breast cancer and other solid tumors. - **Dexrazoxane** acts as a cardioprotective agent by chelating iron and reducing the formation of free radicals associated with anthracycline-induced cardiotoxicity. It does not compromise the antitumor efficacy of epirubicin but significantly reduces the risk of cardiac events when administered concurrently. This combination may be considered particularly in patients at increased risk for anthracycline-induced cardiotoxicity or those receiving high cumulative doses of epirubicin[3][4][5][6]. The primary indication for this regimen is advanced or high-risk breast cancer.