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**palbociclib + irinotecan + temozolomide** is a combination regimen composed of three small molecule chemotherapeutic drugs developed for use in pediatric and young adult patients with recurrent or refractory solid tumors, most notably Ewing sarcoma. - **Palbociclib** is a highly selective, reversible, small molecule inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), blocking cell cycle progression from G1 to S phase and inhibiting tumor cell proliferation. - **Irinotecan** is a topoisomerase I inhibitor that causes DNA strand breaks, leading to apoptosis in rapidly dividing cells. - **Temozolomide** is an oral alkylating agent that methylates DNA, ultimately causing DNA damage and cell death in tumor cells. This regimen is being studied to determine if the addition of palbociclib to irinotecan and temozolomide improves outcomes (such as event-free survival) compared to chemotherapy alone in Ewing sarcoma. The developer and principal sponsor for these studies is Pfizer. The combination is administered in repeating 21-day cycles, with palbociclib given orally, irinotecan intravenously, and temozolomide orally (or intravenously if necessary)[6][7][2][5].
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