doxorubicin + vinblastine + ifosfamide + mesna

This combination is a multi-agent chemotherapy regimen comprised of four drugs: **doxorubicin** (an anthracycline topoisomerase II inhibitor causing DNA damage and cell death), **vinblastine** (a vinca alkaloid that disrupts microtubule formation, inhibiting mitosis), **ifosfamide** (an alkylating agent that cross-links DNA), and **mesna** (a uroprotective agent that neutralizes toxic metabolites of ifosfamide, preventing hemorrhagic cystitis). The regimen is designed for the treatment of certain aggressive cancers, such as **locally advanced or metastatic soft tissue sarcoma**; all individual agents are established anticancer drugs. Mesna itself is not a cytotoxic agent but is essential for preventing the specific urotoxicity of ifosfamide. Each component has unique toxicity profiles and dose-limiting effects. The combination may be used in high-risk cancers or refractory settings in protocols where multi-agent chemotherapy is indicated[2][3][4].