VAMP regimen

[2] Furthermore, the work of Howard Skipper, who argued that every remaining cancer cell in the body must be eradicated in order to ensure the survival of the patient, shifted clinical practice towards more aggressive chemotherapy regimens.

[2] Importantly, Skipper also established that the use of multiple chemotherapy drugs at once provided synergistic benefits over single agents.

[3][2] However, the idea of combination chemotherapy was initially met with resistance by researchers concerned about the toxicity of multiple harmful drugs being used simultaneously.

[3] Due to the immense possibilities of combinations and the potential dangers of these aggressive regimens, this trial process was slow and, in the view of some, inefficient.

[3]VAMP includes four drugs, vincristine, amethopterin, mercaptopurine, and prednisone, operating under independent pathways, which work in concert with one another as an anti-tumor therapy.

[3][5] Furthermore, combination chemotherapy allows multiple independently-acting drugs to be administered at their maximum dose, which increases the treatments toxicity to cancer cells without being deadly to the patient.

Vincristine is a drug isolated from the Madagascar periwinkle, first discovered by the Eli Lilly company in 1958 in a search process that involved testing thousands of plant extracts.

[3] Vincristine functions by binding to and inhibiting microtubule production in the mitotic spindle necessary for the cellular replication, halting cell division in metaphase.

[15][16] By interfering with several major enzymes involved in folic acid production, including dihydrofolate reductase, methotrexate disrupts cellular replication.