cyclophosphamide + fluorouracil + methotrexate + vincristine

This is a combination chemotherapy regimen consisting of four cytotoxic agents: cyclophosphamide, fluorouracil (5-fluorouracil), methotrexate, and vincristine. Each drug has a distinct mechanism of action targeting cancer cell proliferation and survival. Cyclophosphamide is an alkylating agent that crosslinks DNA, leading to apoptosis. Fluorouracil and methotrexate are antimetabolites; fluorouracil inhibits thymidylate synthase, disrupting DNA synthesis, while methotrexate inhibits dihydrofolate reductase, blocking folic acid metabolism required for nucleotide synthesis. Vincristine is a vinca alkaloid that disrupts microtubule formation during mitosis. This combination has been used in the treatment of various solid tumors including adenocarcinoma, squamous cell carcinoma, sarcomas (including fibrosarcoma and osteosarcoma), melanoma, pancreatic neoplasms, pharyngeal neoplasms, leiomyosarcoma, synovial sarcoma as well as advanced breast cancer[1][2][3].