cyclophosphamide + fluorouracil + folinic acid + mitoxantrone

This is a multi-agent chemotherapy regimen composed of four drugs: - Cyclophosphamide (an alkylating agent) - Fluorouracil (also known as 5-FU, an antimetabolite) - Folinic acid (leucovorin, a reduced form of folic acid used to enhance the effects of fluorouracil) - Mitoxantrone (a topoisomerase II inhibitor/anthracenedione) The combination is primarily investigated and used for the treatment of advanced or metastatic breast cancer. Each component has a distinct mechanism: - Cyclophosphamide crosslinks DNA strands to prevent cell division. - Fluorouracil inhibits thymidylate synthase and interferes with DNA synthesis. - Folinic acid stabilizes the binding of fluorouracil to thymidylate synthase, enhancing its cytotoxicity. - Mitoxantrone intercalates into DNA and inhibits topoisomerase II, leading to breaks in DNA strands and apoptosis. This regimen has been studied in phase II clinical trials for advanced breast cancer. The addition of cyclophosphamide may increase toxicity without clear survival benefit compared to regimens omitting it[1][2][4]. The main dose-limiting toxicity is neutropenia.

Other names

cyclophosphamide, 5-fluorouracil, folinic acid, mitoxantrone combinationCNFM regimen