cyclophosphamide + docetaxel + epirubicin + fluorouracil + pertuzumab + trastuzumab

This is a multi-agent combination chemotherapy and targeted therapy regimen used primarily for the treatment of HER2-positive breast cancer. The regimen includes: - Cyclophosphamide (an alkylating agent) - Docetaxel (a taxane-class microtubule inhibitor) - Epirubicin (an anthracycline antibiotic, DNA intercalator and topoisomerase II inhibitor) - Fluorouracil (5-FU, a pyrimidine analog antimetabolite inhibiting thymidylate synthase) - Pertuzumab and Trastuzumab (both monoclonal antibodies targeting the human epidermal growth factor receptor 2 [HER2], but binding to different domains). The combination leverages cytotoxic chemotherapy agents with dual HER2 blockade by pertuzumab and trastuzumab, which bind to distinct epitopes on the HER2 receptor. This approach inhibits tumor cell proliferation via direct cytotoxicity, disruption of HER2 signaling pathways, antibody-dependent cellular cytotoxicity, and prevention of receptor dimerization. This regimen is typically used in neoadjuvant or adjuvant settings for early-stage or locally advanced HER2-positive breast cancer as well as in metastatic disease[1][3][5][7].