mitomycin C + nimustine + methotrexate + ganoderic acid

This is an investigational combination of four agents with different mechanisms of action, which may be considered for cancer therapy, especially for advanced solid tumors. Mitomycin C is an antineoplastic antibiotic and alkylating agent that cross-links DNA, inhibiting DNA synthesis and causing tumor cell death[9]. Nimustine (ACNU) is a nitrosourea alkylating agent also used in cancer chemotherapy. Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, interfering with DNA and RNA synthesis. Ganoderic acid (a group of triterpenoids from the mushroom *Ganoderma lucidum*) is a bioactive natural product that has shown in vitro anticancer effects, possibly via inhibiting glucose transporters (e.g., GLUT1, GLUT3) to starve cancer cells of sugar, and may also inhibit proliferation and invasion of cancer cells through unclear mechanisms[2][6]. The rationale for this combination is to target cancer cells with both conventional chemotherapy and a natural compound that may modulate metabolism and immune response. No clinical studies or standardized regimen have been published for this exact four-drug combination.