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Vincristine + actinomycin-D + ifosfamide is a combination chemotherapy regimen commonly referred to as VAI. It is primarily used in the treatment of Ewing's sarcoma, a rare type of bone and soft tissue cancer that most often affects teenagers and young adults. Each component has a distinct mechanism of action: - Vincristine is a vinca alkaloid that inhibits microtubule formation in mitotic spindle fibers, arresting cell division. - Actinomycin D (also known as dactinomycin) intercalates into DNA and inhibits RNA synthesis by blocking RNA polymerase. - Ifosfamide is an alkylating agent that crosslinks DNA strands, leading to inhibition of DNA replication and cell death. The combination targets rapidly dividing cells such as cancer cells. The drugs are administered intravenously in cycles following surgery or after initial induction chemotherapy with other regimens like VIDE. Mesna may be co-administered to protect against bladder toxicity from ifosfamide[1][5].
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