epirubicin + cyclophosphamide + capecitabine + paclitaxel + carboplatin + pembrolizumab

This is a multi-agent combination regimen consisting of six drugs—epirubicin, cyclophosphamide, capecitabine, paclitaxel, carboplatin, and pembrolizumab—used primarily in the neoadjuvant or adjuvant treatment of high-risk early-stage triple-negative breast cancer (TNBC). The regimen combines several classes of chemotherapeutic agents with an immune checkpoint inhibitor: - **Epirubicin** is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II. - **Cyclophosphamide** is an alkylating agent that crosslinks DNA. - **Capecitabine** is a prodrug converted to 5-fluorouracil (5-FU), inhibiting thymidylate synthase and interfering with DNA synthesis. - **Paclitaxel** stabilizes microtubules and prevents cell division. - **Carboplatin** forms platinum-DNA adducts leading to apoptosis. - **Pembrolizumab** is a monoclonal antibody targeting PD-1 on T cells, blocking its interaction with PD-L1/PD-L2 to enhance anti-tumor immunity. The combination leverages cytotoxic chemotherapy for direct tumor cell killing alongside immunotherapy to stimulate the patient’s immune response against cancer. This approach has demonstrated improved pathological complete response rates and event-free survival in clinical trials for TNBC[2][3][4].