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Epirubicin + cyclophosphamide followed by taxane is a sequential multi-agent chemotherapy regimen primarily used as adjuvant treatment for early-stage and node-positive breast cancer. The regimen typically consists of initial cycles of epirubicin (an anthracycline antibiotic) and cyclophosphamide (an alkylating agent), administered together, followed by a taxane such as docetaxel or paclitaxel. Epirubicin intercalates into DNA and inhibits topoisomerase II activity, leading to DNA strand breaks and apoptosis. Cyclophosphamide crosslinks DNA strands through alkylation, preventing cell division. Taxanes stabilize microtubules and inhibit their depolymerization during mitosis, resulting in cell cycle arrest and apoptosis. This combination exploits different mechanisms to maximize cytotoxicity against rapidly dividing tumor cells[1][3][5]. The regimen is widely used in HER2-negative breast cancer patients but may also be considered for other subtypes.
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