etoposide + cytarabine + vincristine + dexamethasone

This is a multi-agent chemotherapy regimen composed of four drugs: - **Etoposide** is a topoisomerase II inhibitor that induces DNA strand breaks, leading to apoptosis in rapidly dividing cells. - **Cytarabine** (also known as Ara-C) is an antimetabolite that inhibits DNA synthesis, primarily affecting cells in the S phase of the cell cycle. - **Vincristine** is a vinca alkaloid that disrupts microtubule formation, arresting mitosis and causing cell death. - **Dexamethasone** is a synthetic glucocorticoid corticosteroid with anti-inflammatory and immunosuppressive properties; it also has direct cytotoxic effects on certain hematologic malignancies. This combination targets multiple pathways involved in cancer cell proliferation and survival. It has been used or considered for treatment of various hematological malignancies, including refractory lymphomas and multiple myeloma. The regimen leverages non-overlapping mechanisms to maximize antitumor activity while managing resistance[1][2][7].