topotecan + cyclophosphamide + cisplatin + doxorubicin + etoposide + ifosfamide + carboplatin

A multi-agent chemotherapy combination regimen used primarily in the treatment of high-risk neuroblastoma and small cell lung cancer. This regimen incorporates several classes of antineoplastic agents including topoisomerase inhibitors (topotecan, etoposide), alkylating agents (cyclophosphamide, ifosfamide, cisplatin, carboplatin), and an anthracycline (doxorubicin). The search results specifically mention a Thai Pediatric Oncology Group (ThaiPOG) protocol for high-risk neuroblastoma that uses a sequential combination of these agents. This induction regimen consists of 6 cycles with different drug combinations administered in sequence: - Cycles 1-2: Topotecan and cyclophosphamide - Cycles 3 and 5: Cisplatin and etoposide - Cycles 4 and 6: Cyclophosphamide, doxorubicin, and vincristine The primary dose-limiting toxicity of these combination regimens is myelosuppression, particularly neutropenia. Other common adverse effects include febrile neutropenia, mucositis, diarrhea, and elevated renal function. Studies have shown that the sequence of drug administration can significantly impact both efficacy and toxicity profiles. The ThaiPOG protocol demonstrated favorable treatment responses with minimal toxicity in patients with high-risk neuroblastoma.