cyclophosphamide + doxorubicin + paclitaxel + talimogene laherparepvec

This is a combination regimen consisting of three chemotherapeutic agents—cyclophosphamide, doxorubicin, and paclitaxel—together with talimogene laherparepvec (T-VEC). Cyclophosphamide is an alkylating agent that crosslinks DNA, leading to cell death. Doxorubicin is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II, resulting in cytotoxicity. Paclitaxel stabilizes microtubules and prevents their depolymerization, inhibiting cell division. Talimogene laherparepvec is an oncolytic virus therapy derived from genetically modified herpes simplex virus type 1 (HSV-1), designed to selectively replicate within tumor cells and express granulocyte macrophage colony-stimulating factor (GM-CSF), promoting direct tumor lysis and stimulating systemic anti-tumor immune responses[4][5][7]. This combination aims to leverage both cytotoxic chemotherapy and immunotherapy for enhanced anti-cancer efficacy.