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Doxorubicin hydrochloride liposome + irinotecan is a combination chemotherapy regimen used primarily in the treatment of relapsed or refractory cancers, such as pediatric Wilms tumor. Doxorubicin hydrochloride liposome is a formulation of the anthracycline antibiotic doxorubicin encapsulated in polyethylene glycol-coated (pegylated) liposomes, designed to enhance efficacy and reduce dose-limiting toxicities compared to conventional doxorubicin. It works mainly by intercalating DNA and inhibiting topoisomerase II, leading to DNA strand breaks and apoptosis. Irinotecan is a topoisomerase I inhibitor that prevents repair of single-strand DNA breaks by stabilizing the topoisomerase I-DNA complex, resulting in double-strand breaks and cell death. The combination leverages both mechanisms for synergistic antitumor activity[1][2][3][6]. Liposomal formulations improve pharmacokinetics and tumor targeting while reducing systemic toxicity[1][3].
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