doxorubicin + cisplatin + FOLFOX

This is a multi-agent chemotherapy regimen combining doxorubicin, cisplatin, and the FOLFOX protocol (which itself consists of folinic acid [leucovorin], fluorouracil [5-FU], and oxaliplatin). Each component has a distinct mechanism of action targeting rapidly dividing cancer cells. Doxorubicin is an anthracycline antibiotic that intercalates into DNA, inhibits topoisomerase II, and generates reactive oxygen species leading to apoptosis[7][8]. Cisplatin is a platinum-based agent that forms DNA crosslinks, inhibiting DNA replication and transcription[9]. The FOLFOX regimen combines oxaliplatin (a platinum compound causing DNA crosslinking), 5-fluorouracil (an antimetabolite inhibiting thymidylate synthase), and leucovorin (which enhances 5-FU activity)[6]. This combination aims to maximize cytotoxicity against tumor cells by attacking multiple cellular targets. It has been investigated in clinical trials for advanced gastric cancer with peritoneal metastases using pressurized intraperitoneal aerosol chemotherapy (PIPAC) for doxorubicin/cisplatin followed by systemic FOLFOX[1].