topotecan + irinotecan + paclitaxel + temozolomide

This therapeutic combination consists of four distinct chemotherapeutic agents—topotecan, irinotecan, paclitaxel, and temozolomide—being evaluated as second-line treatment options in a Phase I/II umbrella study for recurrent, extensive-stage small cell lung cancer (ES-SCLC). The study, sponsored by the Cancer Institute and Hospital, Chinese Academy of Medical Sciences, utilizes these agents as part of a molecularly-guided treatment strategy. Topotecan and irinotecan are topoisomerase I inhibitors that stabilize the cleavable complex between DNA and the enzyme, leading to lethal double-strand breaks during DNA replication. Paclitaxel is a taxane that promotes microtubule assembly and prevents disassembly, resulting in mitotic arrest. Temozolomide is an oral alkylating agent that methylates DNA, primarily at the O6 position of guanine, which triggers cell cycle arrest and apoptosis when the mismatch repair system fails to resolve the lesion.

Other names

Topotecan/Irinotecan/Paclitaxel/Temozolomide