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A combination therapy consisting of sirolimus (an mTOR inhibitor), cyclophosphamide (an alkylating agent), and topotecan (a topoisomerase I inhibitor). This oral regimen is administered on a metronomic schedule and has been studied primarily in pediatric and adolescent patients with relapsed or refractory solid tumors. The combination has demonstrated modulation of angiogenic pathways in biomarker studies.
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