temozolomide + thiotepa + carboplatin + 13-cis-retinoic acid

This is a combination chemotherapy regimen consisting of four agents—temozolomide, thiotepa, carboplatin, and 13-cis-retinoic acid—used primarily in the treatment of recurrent or refractory malignant brain tumors. Temozolomide is an oral alkylating agent that methylates DNA, leading to tumor cell death. Thiotepa and carboplatin are both alkylating agents that crosslink DNA and disrupt cancer cell replication. 13-cis-retinoic acid (also known as isotretinoin) is a retinoid that induces differentiation and apoptosis in tumor cells. This regimen has been studied with high-dose chemotherapy followed by autologous stem cell rescue (ASCR), then maintenance therapy with 13-cis-retinoic acid, particularly in pediatric patients with recurrent/refractory medulloblastoma/PNET, CNS germ cell tumors, ependymomas, high-grade glioma, and other malignant brain tumors[1][2][3][7]. The combination leverages multiple mechanisms to maximize antitumor activity while using stem cell rescue to mitigate myelosuppression from intensive chemotherapy.

Other names

temozolomide + thiotepa + carboplatin + 13-cis-retinoic acidTMZ/Thiotepa/Carboplatin + ASCR and Isotretinoin