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This combination chemotherapy regimen consists of four cytotoxic agents commonly used in the treatment of breast cancer and other solid tumors. - **Fluorouracil** (5-FU) is an antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis. - **Doxorubicin** is an anthracycline antibiotic that intercalates into DNA and inhibits topoisomerase II, leading to DNA strand breaks and apoptosis. - **Cyclophosphamide** is an alkylating agent that crosslinks DNA strands, preventing cell division and causing cell death. - **Docetaxel** is a taxane that stabilizes microtubules against depolymerization, inhibiting mitosis and promoting apoptosis[6]. The combination of these drugs has been used as adjuvant or neoadjuvant therapy in node-positive or high-risk early breast cancer (notably as the FAC-D or TAC regimen when epirubicin replaces doxorubicin)[4][6]. The addition of docetaxel to the standard FAC regimen was developed to improve efficacy compared with older regimens[4]. This multi-agent protocol increases cytotoxicity but also toxicity risk; primary prophylaxis with granulocyte colony-stimulating factor (G-CSF) may be recommended due to a high risk of febrile neutropenia[8].
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