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temozolomide + bevacizumab + irinotecan is an investigational combination chemotherapy and anti-angiogenic regimen. It consists of three active agents: temozolomide (an oral small-molecule DNA alkylating agent), bevacizumab (a recombinant humanized monoclonal antibody targeting VEGF-A to block angiogenesis), and irinotecan (a small-molecule topoisomerase I inhibitor prodrug). This combination has been evaluated in clinical trials for various aggressive malignancies, including newly diagnosed and recurrent glioblastoma, relapsed or refractory high-risk neuroblastoma, and desmoplastic small round cell tumor (DSRCT). The regimen is designed to exploit the synergistic effects of DNA damage, topoisomerase inhibition, and angiogenesis blockade. While generally reported to be tolerable with manageable hematologic and gastrointestinal toxicities, its efficacy has been moderate, and it is not a single branded product developed by a single company.
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