etoposide + vincristine + doxorubicin + cytarabine

This regimen is a combination chemotherapy protocol incorporating four cytotoxic agents: **etoposide**, **vincristine**, **doxorubicin**, and **cytarabine**. These are all small molecule antineoplastic drugs used to treat various hematologic malignancies by different mechanisms of interfering with DNA synthesis, mitosis, or cell replication. The combination is not standardized under a unique protocol name in the literature, but similar combinations are found in protocols for aggressive lymphomas and leukemias, leveraging their synergistic cytotoxic effects. Etoposide is a topoisomerase II inhibitor, vincristine disrupts microtubule formation, doxorubicin intercalates DNA and inhibits topoisomerase II, while cytarabine is a cytidine analog inhibiting DNA synthesis. Such combination regimens are commonly used to maximize cancer cell kill and overcome drug resistance.