doxorubicin + vincristine + ifosfamide + mesna

This is a combination chemotherapy regimen comprising **doxorubicin** (an anthracycline antineoplastic agent, topoisomerase II inhibitor), **vincristine** (a vinca alkaloid, microtubule inhibitor), **ifosfamide** (an alkylating agent), and **mesna** (a uroprotective agent used specifically to prevent hemorrhagic cystitis caused by oxazaphosphorine chemotherapy such as ifosfamide). This combination has primarily been investigated in the treatment of advanced or metastatic soft tissue sarcoma and Ewing sarcoma, and is administered intravenously in cycles. **Mesna** is not an anticancer agent itself but is essential for uroprotection during ifosfamide therapy. The mechanism involves inhibition of DNA synthesis (doxorubicin, ifosfamide), disruption of mitotic spindle formation (vincristine), and detoxification of urotoxic metabolites (mesna)[3][7].