fluorouracil + doxorubicin + cyclophosphamide + simvastatin

This is a combination therapy consisting of three established chemotherapeutic agents—fluorouracil (5-FU), doxorubicin (also known as adriamycin), and cyclophosphamide—together with the statin drug simvastatin. The standard chemotherapy regimen of fluorouracil, doxorubicin, and cyclophosphamide (FAC) is widely used for the treatment of breast cancer, particularly in neoadjuvant or adjuvant settings. Each component acts via a distinct mechanism to inhibit cancer cell proliferation and survival: - Fluorouracil is an antimetabolite that inhibits thymidylate synthase, disrupting DNA synthesis. - Doxorubicin intercalates into DNA and inhibits topoisomerase II, leading to DNA damage. - Cyclophosphamide is an alkylating agent that crosslinks DNA strands. Simvastatin is a lipid-lowering agent that inhibits HMG-CoA reductase in the mevalonate pathway. Preclinical studies suggest statins may have anti-tumor effects by promoting apoptosis and inhibiting cell proliferation through interference with Ras/Rho signaling pathways. Clinical trials have evaluated this four-drug combination in locally advanced breast cancer (LABC). The addition of simvastatin to FAC has shown trends toward improved objective response rates and pathological responses compared to FAC alone; however, statistical significance was not always reached. Simvastatin may enhance chemotherapy efficacy by sensitizing tumor cells to cytotoxic agents through modulation of cellular signaling pathways involved in drug resistance[1][2][6][8].

Other names

FAC + simvastatin5-fluorouracil + adriamycin + cyclophosphamide + simvastatin