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This is a combination chemotherapy regimen consisting of five agents: mitomycin C, epirubicin, cisplatin, 5-fluorouracil (5-FU), and leucovorin. Each component has a distinct mechanism of action targeting cancer cells through different pathways: - **Mitomycin C** is an alkylating agent that crosslinks DNA, inhibiting DNA synthesis and function. - **Epirubicin** is an anthracycline antibiotic that intercalates into DNA and inhibits topoisomerase II, leading to DNA strand breaks. - **Cisplatin** forms platinum-DNA adducts causing crosslinking and apoptosis. - **5-Fluorouracil (5-FU)** is a pyrimidine analog that inhibits thymidylate synthase, disrupting DNA synthesis. - **Leucovorin** enhances the binding of 5-FU to thymidylate synthase, increasing its cytotoxicity. This regimen (sometimes referred to as MEPFL) has been studied as induction chemotherapy for advanced nasopharyngeal carcinoma[2] and in other gastrointestinal cancers. The combination aims to maximize antitumor efficacy by attacking cancer cells via multiple mechanisms.
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