vincristine + cyclophosphamide + melphalan

This is a **multi-agent chemotherapy regimen** consisting of **vincristine**, **cyclophosphamide**, and **melphalan**. All three are small molecule antineoplastic agents, each with a distinct mechanism of action. Vincristine is a vinca alkaloid that inhibits microtubule formation, cyclophosphamide is an alkylating agent that crosslinks DNA, and melphalan is a nitrogen mustard derivative that also acts as an alkylating agent to prevent DNA and RNA synthesis. This combination regimen has been used in the treatment of hematologic malignancies such as multiple myeloma and chronic lymphocytic leukemia, typically as part of a broader combination regimen with other drugs (e.g., prednisolone or prednisone). The use of multi-drug chemotherapy protocols targets cancer cells through multiple cytotoxic mechanisms for greater efficacy, especially in advanced disease[1][2][6].