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A combination regimen of the small-molecule multikinase inhibitor sorafenib and the topoisomerase I inhibitor topotecan, investigated primarily in oncology. Sorafenib inhibits serine/threonine kinases RAF (CRAF, BRAF) and multiple receptor tyrosine kinases involved in tumor angiogenesis and proliferation, including VEGFR-1/2/3, PDGFR-β, FLT3, KIT, and RET, thereby exerting antiangiogenic and antiproliferative effects. Topotecan is a camptothecin analog that stabilizes the topoisomerase I–DNA complex, causing replication-induced DNA breaks and apoptosis. The combination has been evaluated in platinum-resistant ovarian cancer (including as combination and maintenance), recurrent/refractory small cell lung cancer, and pediatric refractory/recurrent solid tumors and sarcomas, with dose-limiting hematologic toxicity frequently determining tolerability.
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