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Topotecan + pegylated doxorubicin is a combination chemotherapy regimen used primarily for the treatment of recurrent or advanced ovarian cancer, especially after failure of first-line platinum-based chemotherapy. Topotecan is a small molecule inhibitor of DNA topoisomerase I, an enzyme essential for DNA replication and transcription; it stabilizes the cleavable complex between DNA and topoisomerase I, leading to double-stranded DNA breaks and apoptosis in rapidly dividing cells. Pegylated liposomal doxorubicin (PLDH) is an anthracycline antibiotic encapsulated in a polyethylene glycol-coated liposome, which enhances its circulation time and reduces cardiotoxicity compared to conventional doxorubicin. Doxorubicin intercalates into DNA and inhibits topoisomerase II, preventing replication and leading to cell death. The combination exploits complementary mechanisms targeting different aspects of tumor cell proliferation[1][2][4][5][6][8].
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