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A **combination chemotherapy regimen** consisting of four cytotoxic agents: **etoposide** (a topoisomerase II inhibitor), **vincristine** (a vinca alkaloid that inhibits microtubule polymerization), **doxorubicin** (an anthracycline antibiotic that intercalates DNA and inhibits topoisomerase II), and **cyclophosphamide** (an alkylating agent that crosslinks DNA). This combination is used predominantly in the treatment of aggressive lymphomas, such as non-Hodgkin lymphoma and cutaneous T-cell lymphoma, and forms the core of the EPOCH regimen (which adds prednisone) and variants such as CHOEP (which adds prednisone to CHOP + etoposide). The regimen employs drugs with different mechanisms to synergistically target rapidly dividing cancer cells, aiming to prevent drug resistance and maximize cell kill. The individual agents are each FDA-approved as single agents for cancer treatment[2][3][7][8].
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