ribociclib + topotecan + temozolomide

**Ribociclib + topotecan + temozolomide** is an investigational combination regimen being studied primarily in pediatric patients with relapsed or refractory neuroblastoma and other solid tumors, including medulloblastoma, high-grade glioma, malignant rhabdoid tumors, and rhabdomyosarcoma. - **Ribociclib** is a selective inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6), blocking cell cycle progression from G1 to S phase and thus inhibiting tumor cell proliferation. - **Topotecan** is a topoisomerase I inhibitor that induces DNA damage by preventing DNA unwinding, leading to apoptosis in cancer cells. - **Temozolomide** is an alkylating agent that damages DNA through methylation, resulting in cell cycle arrest and apoptosis. This multi-agent regimen (often referenced as TOTEM) is under evaluation in early-phase trials for pediatric cancers, aiming to exploit synergy between cell cycle inhibition and DNA damage to improve antitumor activity, especially in patients with relevant pathway alterations (cell cycle or DNA repair pathways)[1][2][3][4][5][6][7][10].

Other names

ribociclib + topotecan + temozolomide (TOTEM)