epirubicin + cyclophosphamide + Xihuang Pill + docetaxel

This is a combination therapy consisting of three conventional chemotherapeutic agents—epirubicin, cyclophosphamide, and docetaxel—together with Xihuang Pill, a traditional Chinese medicine (TCM) formulation. - **Epirubicin** is an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II, leading to inhibition of DNA replication and RNA synthesis. - **Cyclophosphamide** is an alkylating agent that crosslinks DNA strands, resulting in cell death. - **Docetaxel** is a taxane that stabilizes microtubules and prevents their depolymerization, thereby inhibiting cell division. - **Xihuang Pill** (XHP) contains four main ingredients: Boswellia carteri (olibanum), Commiphora myrrha (myrrh), Moschus moschiferus (musk), and Calculus bovis (bovine bezoar). It has been used as an adjuvant therapy in cancer treatment for its purported effects on promoting blood circulation, reducing inflammation, modulating immunity, inducing apoptosis in tumor cells via pathways such as PI3K-Akt-mTOR and NF-kB signaling, inhibiting angiogenesis and metastasis, improving quality of life during chemotherapy regimens[1][2][6][7][9]. The combination aims to enhance antitumor efficacy while potentially reducing chemotherapy-induced toxicities.