epirubicin + cyclophosphamide + epirubicin + paclitaxel

The "EC + EP" regimen refers to a sequential chemotherapy protocol used primarily in the treatment of metastatic or high-risk early breast cancer. It consists of two distinct combinations administered in sequence: - **EC** (epirubicin and cyclophosphamide): Epirubicin is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II, leading to DNA damage and apoptosis. Cyclophosphamide is an alkylating agent that crosslinks DNA strands, inhibiting cell replication. - **EP** (epirubicin and paclitaxel): Paclitaxel is a taxane that stabilizes microtubules, preventing their depolymerization during cell division, which leads to mitotic arrest and apoptosis. This sequential approach aims to maximize cytotoxic effects on rapidly dividing cancer cells by using drugs with different mechanisms of action. The regimen has been studied as first-line therapy for metastatic breast cancer; clinical trials have shown comparable efficacy between the two sequences (EC followed by EP vs. EP followed by EC), with objective response rates around 55–65%[4].

Other names

EC + EPEC/EPEC-EP regimen