floxuridine + melphalan

This is a combination of two antineoplastic agents, floxuridine and melphalan. Floxuridine is an antimetabolite that acts as a pyrimidine analog, disrupting DNA synthesis by being incorporated into DNA in place of normal pyrimidines, leading to inhibition of cell division. It is primarily used for the palliative management of liver metastases from gastrointestinal malignancies[2]. Melphalan is an alkylating agent (a nitrogen mustard derivative) that crosslinks DNA strands, thereby inhibiting DNA and RNA synthesis and function. It is used in the treatment of multiple myeloma, ovarian carcinoma, and for high-dose conditioning before hematopoietic stem cell transplantation[1]. The combination would be expected to have synergistic cytotoxic effects on rapidly dividing cancer cells through complementary mechanisms—floxuridine interfering with nucleotide incorporation during S-phase and melphalan causing direct DNA damage.