cyclophosphamide + doxorubicin + ganetespib + paclitaxel

This is a four-drug combination regimen consisting of cyclophosphamide, doxorubicin, ganetespib, and paclitaxel. Cyclophosphamide is an alkylating agent that crosslinks DNA to inhibit cell division. Doxorubicin is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II, leading to cytotoxicity in rapidly dividing cells. Paclitaxel is a taxane that stabilizes microtubules and prevents their depolymerization, thereby inhibiting mitosis. Ganetespib is a second-generation small molecule inhibitor of heat shock protein 90 (HSP90), which disrupts the function of multiple oncogenic client proteins involved in cancer cell growth and survival[3][4]. This combination targets multiple pathways critical for tumor proliferation and survival.