mitoxantrone + temozolomide

Mitoxantrone + temozolomide is a combination of two chemotherapeutic agents used primarily in the treatment of recurrent or resistant cancers, particularly glioblastoma and other brain tumors. Mitoxantrone is an anthracenedione-derived antineoplastic agent that intercalates into DNA, inhibits topoisomerase II, and disrupts DNA synthesis and repair, leading to apoptosis. It also suppresses immune cell proliferation and cytokine secretion. Temozolomide is an oral alkylating agent of the imidazotetrazine class that methylates DNA at several positions (notably O6-guanine), causing cytotoxicity through induction of DNA damage and subsequent apoptosis when repair mechanisms are overwhelmed or deficient. The combination leverages complementary mechanisms to enhance antitumor efficacy, especially in tumors with resistance to single-agent therapy[1][3][6].