vinorelbine + gemcitabine + docetaxel + pemetrexed

This is a combination chemotherapy regimen consisting of four cytotoxic agents: vinorelbine, gemcitabine, docetaxel, and pemetrexed. Each drug has a distinct mechanism of action targeting rapidly dividing cancer cells: *Vinorelbine* is a semi-synthetic vinca alkaloid that inhibits microtubule assembly, disrupting mitosis. *Gemcitabine* is a nucleoside analog (antimetabolite) that incorporates into DNA during replication and inhibits DNA synthesis by blocking ribonucleotide reductase. *Docetaxel* is a taxane that stabilizes microtubules and prevents their depolymerization, leading to cell cycle arrest in the M phase. *Pemetrexed* is an antifolate antimetabolite that inhibits several folate-dependent enzymes involved in nucleotide synthesis (thymidylate synthase, dihydrofolate reductase, glycinamide ribonucleotide formyltransferase), thereby blocking DNA and RNA synthesis[7][6]. These drugs are primarily used for the treatment of non-small cell lung cancer (NSCLC) and malignant pleural mesothelioma—either as monotherapies or in various two-drug combinations; however, the use of all four together as one regimen is not standard clinical practice due to cumulative toxicity concerns[1][2][3]. Each agent has demonstrated efficacy in NSCLC or mesothelioma either alone or with other partners.

Other names

vinorelbine tartrategemcitabine hydrochloridedocetaxel anhydrouspemetrexed disodium