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A multi-agent chemotherapy regimen combining docetaxel, cisplatin, 5-fluorouracil, and leucovorin. Docetaxel is a taxane that stabilizes microtubules and inhibits depolymerization, leading to mitotic arrest. Cisplatin forms intra- and interstrand DNA crosslinks causing DNA damage and apoptosis. 5-fluorouracil is a fluoropyrimidine antimetabolite that inhibits thymidylate synthase and incorporates into RNA and DNA, disrupting nucleic acid synthesis; leucovorin (folinic acid) enhances 5-FU’s inhibition of thymidylate synthase by stabilizing the ternary complex. The combination has been studied as induction or systemic therapy in solid tumors, notably squamous cell carcinoma of the head and neck and upper gastrointestinal malignancies including gastric and esophagogastric cancers, with dose-limiting toxicities mainly neutropenia and mucositis.
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