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**AQ4N + temozolomide + radiotherapy** is an experimental multi-modality treatment regimen evaluated for **newly diagnosed glioblastoma** and other malignant gliomas. - **AQ4N** (also known as banoxantrone) is a prodrug bioreductive cytotoxin that is converted under hypoxic tumor conditions to AQ4, a DNA-intercalating agent and topoisomerase II inhibitor. - **Temozolomide** is an oral alkylating agent that induces DNA methylation and damage, leading to apoptosis of rapidly dividing tumor cells. - **Radiotherapy** (RT) induces DNA damage and cytotoxicity in tumor cells, often with enhanced efficacy when combined with agents that sensitize cells to radiation or hypoxic cytotoxins. Combining these three modalities is intended to improve tumor cell killing, leveraging both hypoxic tumor targeting (via AQ4N) and DNA damage (from temozolomide and RT). Clinical evaluations have focused on safety, tolerability, and preliminary efficacy, especially in glioblastoma[1][3]. This regimen is not an approved standard of care and remains investigational.
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