Chemotherapy Regimens

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A chemotherapy regimen is a regimen for chemotherapy, defining the drugs to be used, their dosage, the frequency and duration of treatments, and other considerations. In modern oncology, many regimens combine several chemotherapy drugs in combination chemotherapy. The majority of drugs used in cancer chemotherapy are cytostatic, many via cytotoxicity.

A fundamental philosophy of medical oncology, including combination chemotherapy, is that different drugs work through different mechanisms, and that the results of using multiple drugs will be synergistic to some extent. Because they have different dose-limiting adverse effects, they can be given together at full doses in chemotherapy regimens.[1]

The first successful combination chemotherapy was MOPP, introduced in 1963 for lymphomas.

The term "induction regimen" refers to a chemotherapy regimen used for the initial treatment of a disease. A "maintenance regimen" refers to the ongoing use of chemotherapy to reduce the chances of a cancer recurring or to prevent an existing cancer from continuing to grow.[2]

Chemotherapy regimens are often identified by acronyms, identifying the agents used in the drug combination. However, the letters used are not consistent across regimens, and in some cases - for example, "BEACOPP" - the same letter combination is used to represent two different treatments.[3]

There is no widely accepted naming convention or standard for the nomenclature of chemotherapy regimens. For example, either generic or brand names may be used for acronyms. This page merely lists commonly used conventions.

List of chemotherapy regimen acronyms

Name Components Example of uses, and other notes
7+3, also known as DA or DAC in case of daunorubicin, or IA or IAC in case of idarubicin use 7 days of Ara-C (cytarabine) plus 3 days of an anthracycline antibiotic, either daunorubicin (DA or DAC variant) or idarubicin (IA or IAC variant) Acute myelogenous leukemia, excluding acute promyelocytic leukemia
ABVD doxorubicin (Adriamycin), bleomycin, vinblastine, dacarbazine Hodgkin's lymphoma
AC doxorubicin (Adriamycin), cyclophosphamide breast cancer
BACOD bleomycin, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), dexamethasone Non-Hodgkin lymphomas
BEACOPP bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), procarbazine, prednisone Hodgkin's lymphoma
BEP bleomycin, etoposide, platinum agent testicular cancer, germ cell tumors
CA cyclophosphamide, doxorubicin (Adriamycin) (same as AC) breast cancer
CAF cyclophosphamide, doxorubicin (Adriamycin), fluorouracil (5-FU) breast cancer
CAPOX or XELOX capecitabine and oxaliplatin colorectal cancer
CAV cyclophosphamide, doxorubicin (Adriamycin), vincristine lung cancer
CBV cyclophosphamide, BCNU (carmustine), VP-16 (etoposide) lymphoma
CHOEP cyclophosphamide, hydroxydaunorubicin (doxorubicin), etoposide, vincristine (Oncovin), prednisone Non-Hodgkin lymphomas
CEPP cyclophosphamide, etoposide, procarbazine, prednisone Non-Hodgkin Lymphomas
ChlVPP/EVA chlorambucil, vincristine (Oncovin), procarbazine, prednisone, etoposide, vinblastine, doxorubicin (Adriamycin) Hodgkin's lymphoma
CHOP cyclophosphamide, hydroxydaunorubicin (doxorubicin), vincristine (Oncovin), prednisone non-Hodgkin lymphoma
CHOP-R or R-CHOP CHOP + rituximab B cell non-Hodgkin lymphoma
ClaPD clarithromycin, pomalidomide, dexamethasone multiple myeloma
CMF cyclophosphamide, methotrexate, fluorouracil (5-FU) breast cancer
CMV cisplatin, methotrexate, vinblastine transitional bladder carcinoma
COP or CVP cyclophosphamide, Oncovin (vincristine), prednisone non-Hodgkin lymphoma in patients with history of cardiovascular disease
COPP cyclophosphamide, Oncovin (vincristine), procarbazine, prednisone Hodgkin's lymphoma
CT or TC docetaxel (Taxotere), cyclophosphamide breast cancer
CTD cyclophosphamide, thalidomide, dexamethasone AL amyloidosis
CVAD and Hyper-CVAD cyclophosphamide, vincristine, doxorubicin (Adriamycin), dexamethasone aggressive non-Hodgkin lymphoma, lymphoblastic lymphoma, some forms of leukemia
CYBORD cyclophosphamide, bortezomib, dexamethasone multiple myeloma, AL amyloidosis
DA or DAC daunorubicin x 3 days plus ara-C (cytarabine) x 7 days, a variant of 7+3 regimen Acute myeloid leukemia, excluding acute promyelocytic leukemia
DAT daunorubicin, cytarabine (ara-C), tioguanine Acute myeloid leukemia
DCEP dexamethasone, cyclophosphamide, etoposide, platinum agent relapsed or refractory multiple myeloma
DHAP dexamethasone (a steroid hormone), cytarabine (ara-C), platinum agent Non-Hodgkin lymphomas
DHAP-R or R-DHAP dexamethasone (a steroid hormone), cytarabine (ara-C), platinum agent plus rituximab Non-Hodgkin lymphomas
DICE dexamethasone, ifosfamide, cisplatin, etoposide (VP-16) aggressive relapsed lymphomas, progressive neuroblastoma
DT-PACE dexamethasone, thalidomide, platinum agent, doxorubicin (Adriamycin), cyclophosphamide, etoposide multiple myeloma
EC epirubicin, cyclophosphamide breast cancer
ECF epirubicin, cisplatin, fluorouracil (5-FU) gastric cancer and esophageal cancer
EOX epirubicin, oxaliplatin, capecitabine esophageal Cancer, gastric Cancer
EP etoposide, platinum agent testicular cancer, germ cell tumors
EPOCH etoposide, prednisone, vincristine (Oncovin), cyclophosphamide, and hydroxydaunorubicin Non-Hodgkin lymphomas
EPOCH-R or R-EPOCH etoposide, prednisone, vincristine (Oncovin), cyclophosphamide, and hydroxydaunorubicin plus rituximab B cell Non-Hodgkin lymphomas
ESHAP etoposide, methylprednisolone (a steroid hormone), cytarabine (ara-C), platinum agent Non-Hodgkin lymphoma
ESHAP-R or R-ESHAP etoposide, methylprednisolone (a steroid hormone), cytarabine (ara-C), platinum agent plus rituximab Non-Hodgkin lymphoma
FAM fluorouracil, doxorubicin (Adriamycin), mitomycin gastric cancer
FAMTX fluorouracil, doxorubicin (Adriamycin), methotrexate gastric cancer
FCM or FMC fludarabine, cyclophosphamide, mitoxantrone B cell non-Hodgkin lymphoma
FCM-R or R-FCM or R-FMC or FMC-R fludarabine, cyclophosphamide, mitoxantrone plus rituximab B cell non-Hodgkin lymphoma
FM fludarabine, mitoxantrone B cell non-Hodgkin lymphoma
FM-R or R-FM or RFM or FMR fludarabine, mitoxantrone, and rituximab B cell non-Hodgkin lymphoma
FEC fluorouracil (5-FU), epirubicin, cyclophosphamide breast cancer
FL (also known as Mayo) fluorouracil (5-FU), leucovorin (folinic acid) colorectal cancer
FLAG fludarabine, cytarabine, G-CSF relapsed or refractory acute myelogenous leukemia
FLAG-Ida or FLAG-IDA or IDA-FLAG or Ida-FLAG fludarabine, cytarabine, idarubicin, G-CSF relapsed or refractory acute myelogenous leukemia
FLAG-Mito or FLAG-MITO or Mito-FLAG or MITO-FLAG or FLANG mitoxantrone, fludarabine, cytarabine, G-CSF relapsed or refractory acute myelogenous leukemia
FLAMSA fludarabine, cytarabine, amsacrine myelodysplastic syndrome, acute myeloid leukemia
FLAMSA-BU or FLAMSA-Bu fludarabine, cytarabine, amsacrine, busulfan myelodysplastic syndrome, acute myeloid leukemia
FLAMSA-MEL or FLAMSA-Mel fludarabine, cytarabine, amsacrine, melphalan myelodysplastic syndrome, acute myeloid leukemia
FOLFIRI fluorouracil (5-FU), leucovorin (folinic acid), irinotecan colorectal cancer
FOLFIRINOX fluorouracil (5-FU), leucovorin (folinic acid), irinotecan, oxaliplatin pancreatic cancer
FOLFOX fluorouracil (5-FU), leucovorin (folinic acid), oxaliplatin colorectal cancer
GC gemcitabine, cisplatin gemcitabine, dexamethasone, and cisplatin
GDP gemcitabine, dexamethasone, cisplatin Non-Hodgkin lymphomas and Hodgkin lymphoma
GemOx or GEMOX gemcitabine, oxaliplatin Non-Hodgkin lymphomas
GVD gemcitabine, vinorelbine, pegylated liposomal doxorubicin Hodgkin lymphoma
GemOx-R or GEMOX-R or R-GemOx or R-GEMOX gemcitabine, oxaliplatin, rituximab Non-Hodgkin lymphomas
IA or IAC idarubicin x 3 days plus Ara-C (cytarabine) x 7 days, a variant of classical 7+3 regimen Acute myelogenous leukemia, excluding acute promyelocytic leukemia
ICE ifosfamide, carboplatin, etoposide (VP-16) aggressive lymphomas, progressive neuroblastoma
ICE-R or R-ICE or RICE ICE + rituximab high-risk progressive or recurrent lymphomas
IFL irinotecan, leucovorin (folinic acid), fluorouracil colorectal cancer
m-BACOD methotrexate, bleomycin, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), dexamethasone non-Hodgkin lymphoma
MACOP-B methotrexate, leucovorin (folinic acid), doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), prednisone, bleomycin non-Hodgkin lymphoma
MAID mesna, doxorubicin, ifosfamide, dacarbazine soft-tissue sarcoma
MINE mesna, ifosfamide, novantrone, etoposide Non-Hodgkin lymphomas and Hodgkin lymphoma in relapse or refractory cases
MINE-R or R-MINE mesna, ifosfamide, novantrone, etoposide plus rituximab Non-Hodgkin lymphomas and Hodgkin lymphoma in relapse or refractory cases
MMM mitomycin, methotrexate, mitoxantrone breast cancer
MOPP mechlorethamine, vincristine (Oncovin), procarbazine, prednisone Hodgkin's lymphoma
MVAC methotrexate, vinblastine, adriamycin, cisplatin advanced bladder cancer[4]
MVP mitomycin, vindesine, cisplatin lung cancer and mesothelioma
NP cisplatin, vinorelbine non-small cell lung carcinoma
PACE platinum agent, doxorubicin (Adriamycin), cyclophosphamide, etoposide
PCV Procarbazine, CCNU (lomustine), vincristine brain tumors
PEB cisplatin, etoposide, bleomycin non-seminomatous germ cell tumors
PEI cisplatin, etoposide, ifosfamide small-cell lung carcinoma
POMP 6-mercaptopurine (Purinethol), vincristine (Oncovin), methotrexate, and prednisone acute adult leukemia[5]
ProMACE-MOPP methotrexate, doxorubicin (Adriamycin), cyclophosphamide, etoposide + MOPP non-Hodgkin lymphoma
ProMACE-CytaBOM prednisone, doxorubicin (Adriamycin), cyclophosphamide, etoposide, cytarabine, bleomycin, vincristine (Oncovin), methotrexate, leucovorin non-Hodgkin lymphoma
RdC lenalidomide (Revlimid), dexamethasone, cyclophosphamide AL amyloidosis
R-Benda rituximab + bendamustine follicular lymphoma and MALT lymphoma[6]
R-DHAP or DHAP-R rituximab + DHAP; that is, rituximab, dexamethasone (a steroid hormone), cytarabine (ara-C), platinum agent relapsed non-Hodgkin's lymphoma and Hodgkin's lymphoma
R-FCM or FCM-R rituximab + FCM; that is, rituximab, fludarabine, cyclophosphamide, mitoxantrone B cell non-Hodgkin lymphoma
R-ICE or ICE-R or RICE rituximab + ICE; that is, rituximab, ifosfamide, carboplatin, etoposide high-risk progressive or recurrent lymphomas
RVD lenalidomide (Revlimid), bortezomib, dexamethasone
Stanford V doxorubicin (Adriamycin), mechlorethamine, bleomycin, vinblastine, vincristine, etoposide, prednisone Hodgkin lymphoma
TAC or ACT docetaxel (Taxotere) or paclitaxel (Taxol), doxorubicin (Adriamycin), cyclophosphamide breast cancer ("TAC" can also refer to tetracaine-adrenaline-cocaine, used as local anesthetic)
TAD tioguanine, cytarabine (ara-C), daunorubicin acute myeloid leukemia
TC or CT docetaxel (Taxotere), cyclophosphamide breast cancer
TCH paclitaxel (Taxol), carboplatin, trastuzumab (Herceptin) breast cancer with positive HER2/neu receptor
Thal/Dex thalidomide, dexamethasone multiple myeloma
TIP paclitaxel (Taxol), ifosfamide, platinum agent cisplatin (Platinol) testicular cancer, germ cell tumors in salvage therapy
EE-4A vincristine, actinomycin[7] Wilms' tumor[7]
DD-4A vincristine, actinomycin, doxorubicin (Adriamycin)[7] Wilms' tumor[7]
VABCD vinblastine, doxorubicin (Adriamycin), bleomycin, lomustine (CeeNU), dacarbazine MOPP refractory Hodgkin's Lymphoma
VAC vincristine, actinomycin, cyclophosphamide rhabdomyosarcoma
VAD vincristine, doxorubicin (Adriamycin), dexamethasone multiple myeloma
VAMP one of 3 combinations of vincristine and others Hodgkin's lymphoma, leukemia, multiple myeloma
Regimen I vincristine, doxorubicin (Adriamycin), etoposide, cyclophosphamide Wilms' tumor[7]
VAPEC-B vincristine, doxorubicin (Adriamycin), prednisone, etoposide, cyclophosphamide, bleomycin Hodgkin's lymphoma
VD-PACE bortezomib, dexamethasone plus platinum agent, doxorubicin (Adriamycin), cyclophosphamide, etoposide multiple myeloma
VIFUP vinorelbine, cisplatin, fluorouracil locally advanced/metastatic breast cancer
VIP vinblastine, ifosfamide, platinum agent, (etoposide(VP-16) may substitute for vinblastine, making a regimen sometimes referred to as VIP-16)[8][9] testicular cancer, germ cell tumors
VTD-PACE bortezomib (Velcade), thalidomide, dexamethasone plus platinum agent, doxorubicin (Adriamycin), cyclophosphamide, etoposide multiple myeloma

References

  1. ^ Mayer, RJ, Targeted therapy for advanced colorectal cancer -- more is not always better, N Engl J Med. 2009;360:623 which is a [possibly critical and not peer reviewed] comment to Chemotherapy, bevacizumab, and cetuximab in metastatic colorectal cancer.
  2. ^ Cancer.net - Explaining Maintenance Therapy
  3. ^ BEACOPP chemotherapy regimen
  4. ^ MVAC Still the ‘Best Treatment’ for Advanced Bladder Cancer Patients. 1999
  5. ^ POMP combination chemotherapy of adult acute leukemia.
  6. ^ Kiesewetter B, Mayerhoefer ME, Lukas J, Zielinski CC, Müllauer L, Raderer M (2014). "Rituximab plus bendamustine is active in pretreated patients with extragastric marginal zone B cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma)". Ann. Hematol. 93 (2): 249–53. doi:10.1007/s00277-013-1865-3. PMID 23925930. 
  7. ^ a b c d e Treatment of Wilms Tumor at National Cancer Institute. Last Modified: 03/29/2012
  8. ^ El Weshi, A; Memon, M; Raja, M; Bazarbashi, S; Rahal, M; El Foudeh, M; Pai, C; Allam, A; El Hassan, I; Ezzat, A (October 2004). "VIP (etoposide, ifosfamide, cisplatin) in adult patients with recurrent or refractory Ewing sarcoma family of tumors.". American journal of clinical oncology. 27 (5): 529–34. doi:10.1097/01.coc.0000135815.94162.83. PMID 15596925. 
  9. ^ Kosmidis, P; Mylonakis, N; Fountzilas, G; Pavlidis, N; Samantas, E; Karabelis, A; Kattis, K; Skarlos, D (July 1996). "A prospective randomized phase III study in non-small-cell lung cancer comparing cisplatin, ifosfamide, vinblastine (VIP) versus cisplatin, ifosfamide and etoposide (VIP-16). Hellenic Co-Operative Oncology Group.". Annals of Oncology. 7 (5): 517–20. doi:10.1093/oxfordjournals.annonc.a010642. PMID 8839908. 

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