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This is a multi-agent **chemotherapy combination** consisting of six cytotoxic drugs—**melphalan**, **prednisone**, **cyclophosphamide**, **carmustine (BCNU)**, **vincristine**, and **lomustine (MeCCNU)**—primarily used for treating **multiple myeloma**. The regimen acts through **DNA alkylation** (melphalan, cyclophosphamide, carmustine, lomustine), **microtubule inhibition** (vincristine), and **anti-inflammatory/glucocorticoid effects** (prednisone) to induce tumor cell death, achieve rapid disease control, and improve response rates over simpler regimens like melphalan + prednisone. Developed through clinical trials by cooperative oncology groups such as the **Eastern Cooperative Oncology Group (ECOG)**, it showed higher objective response rates (up to 72%) and longer remission durations (median 24 months) compared to melphalan + prednisone, though overall survival benefits were marginal (median ~30-41 months, 5-year survival ~26%). Common toxicities include myelosuppression, nausea, peripheral neuropathy, alopecia, and increased risk of secondary malignancies like myelodysplastic syndrome.[1][2][3]
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