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The combination of **vincristine + irinotecan + temozolomide** (often abbreviated as VIT) is a multi-agent chemotherapy regimen used primarily as a salvage treatment for relapsed or refractory sarcomas in children and young adults, including rhabdomyosarcoma and Ewing sarcoma. - **Vincristine** is a microtubule inhibitor (a vinca alkaloid) that disrupts mitosis. - **Irinotecan** is a camptothecin prodrug converted in vivo to SN-38, which acts as a **topoisomerase I inhibitor**, causing S-phase specific cytotoxicity. - **Temozolomide** is an oral alkylating agent, inducing DNA damage that increases tumor cell sensitivity to topoisomerase I inhibitors. Preclinical and clinical evidence indicates **synergy** between temozolomide and irinotecan (particularly when temozolomide is administered before irinotecan), and vincristine shows additional synergistic effects with the other two drugs in sarcoma treatment. The VIT regimen is primarily indicated for relapsed or refractory rhabdomyosarcoma and certain other pediatric sarcomas, with administration protocols specifying dosing over a 21-day cycle[1][2][3][5][6][8].
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