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**Veliparib + temozolomide** is a combination of the poly (ADP-ribose) polymerase (PARP) inhibitor **veliparib** and the oral alkylating agent **temozolomide**. - **Veliparib** inhibits PARP1 and PARP2, enzymes involved in DNA repair, thereby increasing DNA damage and leading to cancer cell death, particularly in cells deficient in homologous recombination repair[4]. - **Temozolomide** methylates DNA at multiple positions, including the O6 and N7 of guanine and N3 of adenine, leading to cytotoxic DNA lesions and strand breaks[6][4]. - The combination aims to potentiate DNA damage by preventing repair of temozolomide-induced DNA lesions, conferring synergistic anti-tumor activity. - This combination has been investigated primarily in **glioblastoma**, **metastatic breast cancer**, **small-cell lung cancer**, and **acute leukemia**[1][2][3][5]. - Clinical trials have shown that although generally well-tolerated, efficacy improvements over temozolomide alone may be disease and patient population dependent; notable toxicities include hematologic side effects such as thrombocytopenia and neutropenia[2][3].
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