irinotecan + cyclophosphamide

The combination of **irinotecan + cyclophosphamide** is a chemotherapy regimen used in oncology, especially for certain pediatric and adult solid tumors such as neuroblastoma and rhabdomyosarcoma. **Irinotecan** is a topoisomerase I inhibitor that prevents DNA replication, while **cyclophosphamide** is an alkylating agent that cross-links DNA, leading to cell death. The combination exploits these two distinct mechanisms, aiming for enhanced antitumor effect. The regimen is often combined with vincristine (another antimitotic agent) and sometimes dactinomycin, forming VAC/VI (vincristine, actinomycin D, cyclophosphamide / vincristine, irinotecan)[1][2]. The rationale for combining these agents is to improve outcomes while reducing the cumulative dose of cyclophosphamide, a drug with significant long-term toxicity (e.g., infertility), without compromising efficacy[1]. Clinical trials have investigated this combination both as a standard option and in the salvage setting for resistant or recurrent disease[2].

Other names

irinotecan/cyclophosphamidecyclophosphamide/irinotecanVAC/VI (when combined with vincristine and dactinomycin)HD-CCV (high-dose cyclophosphamide/irinotecan/vincristine)