metformin + Myocet + cyclophosphamide

This is a combination therapy consisting of metformin, Myocet (a non-pegylated liposomal formulation of doxorubicin), and cyclophosphamide. Metformin is an oral biguanide antidiabetic agent with demonstrated anti-proliferative and immune-modulating effects in preclinical cancer models, including activation of cytotoxic T cells and inhibition of tumor growth. Myocet is a liposome-encapsulated form of doxorubicin designed to reduce cardiotoxicity while maintaining antitumor efficacy; it acts as a DNA intercalator and topoisomerase II inhibitor. Cyclophosphamide is an alkylating chemotherapeutic agent that crosslinks DNA, leading to cell death, and can be used in both high-dose cytotoxic regimens or low-dose (metronomic) schedules for immunomodulatory effects. The combination has been investigated primarily for breast cancer (notably HER2-negative subtypes), aiming to improve disease-free survival while minimizing toxicity compared to conventional anthracycline regimens[3][6][8]. Preclinical studies suggest the addition of metformin may enhance anti-tumor immunity when combined with chemotherapy[1][2].