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Common Chemotherapies


The following excerpt is taken from Appendix E of Non-Hodgkin's Lymphomas: Making Sense of Diagnosis, Treatment, and Options by Lorraine Johnston, copyright 1999 by O'Reilly & Associates, Inc. For book orders/information, call 1-800-998-9938. Permission is granted to print and distribute this excerpt for noncommercial use as long as the above source is included. The information in this article is meant to educate and should not be used as an alternative for professional medical care.

Many of the chemotherapy regimens shown below are recombinations of CHOP drugs with additional agents, different timing, or different doses. Some, such as LSA2L2 or NHL-BFM, are quite different from CHOP, instead resembling regimens for childhood acute lymphoblastic leukemia, spread over long time periods. Others are unique agents used against specific NHLs, such as psoralen for cutaneous T-cell lymphoma.

Two tables are provided below:

Multi-drug regimen acronyms and their component drugs are shown in the first table. Unfortunately, acronyms have been created over time following few, if any, rules. In a few cases, such as BFM or POG, the acronym stands for a study group, but most often an acronym is assembled from either:

  • The first letters of the generic names of the drugs used.
  • The first letters of the abbreviations for the drug names, such as V used for etoposide (VP-16).
  • Less often, the first letters of the registered trade names, such as Adriamycin for doxorubicin, or Oncovin for vincristine.
Single drug names, abbreviations, trade names, and modes of action are supplied in the second table.

Dose amounts and schedules are not given below, because these may be altered by your doctor to suit your circumstances. In the absence of these amounts and schedules, many of these regimens appear to be almost identical, but dose and schedule do indeed make a considerable difference in tumor response.

Common multi-drug regimens

Acronym

Drugs included

ACOP+

Adriamycin (doxorubicin; DOX), cyclophosphamide (CTX), Oncovin (vincristine; VCR), prednisone (Pred), methotrexate (MTX), hydrocortisone (HC)

ACOP-B

Adriamycin (doxorubicin; DOX), cyclophosphamide (CTX), Oncovin (vincristine; VCR), prednisone (Pred), bleomycin (BLEO)

ACVB

Adriamycin (doxorubicin; DOX), cyclophosphamide (CTX), vindesine (VDS), bleomycin (BLEO)

APO

Adriamycin (doxorubicin; DOX), prednisone (Pred), Oncovin (vincristine; VCR), methotrexate (MTX), l-asparaginase (A-ase), 6-mercaptopurine (6-MP)

BACOP

bleomycin (BLEO), Adriamycin (doxorubicin; DOX), cyclophosphamide (CTX), Oncovin (vincristine; VCR), prednisone (Pred)

BACT

carmustine (BCNU), cytarabine (ARA-C), cyclophosphamide (CTX), 6-thioguanine (6-TG)

BEAC

carmustine (BCNU), etoposide (VP-16), cytarabine (ARA-C), cyclophosphamide (CTX)

BEAM

carmustine (BCNU), etoposide (VP-16), cytarabine (ARA-C), melphalan

BFM (Berlin-
Frankfurt-
Munster study)

prednisone (Pred), vincristine (VCR), daunorubicin (DNR), asparaginase, cyclophosphamide (CTX), cytarabine (ARA-C), methotrexate (MTX), mercaptopurine (6-MP) (See also NHL-BFM 86/90)

BMV-VIP

bleomycin (BLEO), methylprednisone (Pred), vindesine, ifosfamide (IFF), etoposide (VP-16)

CAPOMEt

CHOP with methotrexate and etoposide added

CEPP-Bleo

cyclophosphamide (CTX), etoposide (VP-16), procarbazine (PCB), prednisone (Pred), bleomycin (BLEO)

 

CHOP

cyclophosphamide (CTX), hydroxorubicin (doxorubicin; DOX), Oncovin (vincristine; VCR), prednisone (Pred)

CHOP-BLEO

CHOP with bleomycin (BLEO) added

CHOP plus MTX

CHOP alternating with infusional methotrexate (MTX)

CHVP

cyclophosphamide (CTX), hydroxorubicin (doxorubicin; DOX), teniposide (VM-26), prednisone (Pred)

COMLA

cyclophosphamide (CTX), Oncovin (vincristine; VCR), methotrexate (MTX), leucovorin (Leu), cytarabine (ARA-C)

COMP

cyclophosphamide (CTX), Oncovin (vincristine; VCR), methotrexate (MTX), prednisone (Pred)

COP

CHOP without hydroxorubicin (DOX)

COPAD

Cyclophosphamide (CTX), Oncovin (vincristine; VCR), Prednisone (Pred), ADriamycin (doxorubicin; DOX)

COPAD-M

COPAD with methotrexate (MTX) added

CVP-1

COP with different doses, different timing

DHAP

dexamethasone (DEX), high-dose cytarabine (ARA-C), and cisplatin (CDDP)

DICE

dexamethasone (DEX), ifosfamide (IFF), cisplatin (CDDP), etoposide (VP-16)

EPOCH

etoposide (VP-16), prednisone (Pred), Oncovin (vincristine; VCR), cyclophosphamide (CTX), hydroxorubicin (doxorubicin; DOX)

ESAP

etoposide (VP-16), methylprednisolone (SOL), cytarabine (ARA-C), cisplatin (CDDP)

ESHAP

ESAP with prednisone (Pred) added

ICE

ifosfamide (IFF), carboplatinum, etoposide (VP-16)

IDA/Ara-C

idarubicin (IDA), cytarabine (ARA-C)

IM-VP16

ifosfamide (IFF), methotrexate (MTX), etoposide (VP-16)

 

LSA2L2

cyclophosphamide (CTX), intrathecal methotrexate (MTX IT), vincristine (VCR), daunomycin (DNR), prednisone (Pred), cytarabine (ARA-C), asparaginase (A-ase), thioguanine (6-TG), carmustine (BCNU), and hydroxyurea (HU)

LSA2L2 + MTX

The LSA2L2 regimen supplemented by 10 courses of high-dose methotrexate (MTX)

MACOP-B

methotrexate (MTX), Adriamycin (doxorubicin; DOX), cyclophosphamide (CTX), Oncovin (vincristine; VCR), prednisone (Pred), bleomycin (BLEO), leucovorin (Leu)

m-BACOD

methotrexate (MTX), bleomycin (BLEO), Adriamycin (doxorubicin; DOX), cyclophosphamide (CTX), Oncovin (vincristine; VCR), dexamethasone (DEX), leucovorin (Leu)

M-BACOD

Same as m-BACOD, but with higher doses

Milan protocol

prednisone (Pred), vincristine (VCR), cyclophosphamide (CTX), doxorubicin (DOX), high-dose methotrexate (MTX), cytarabine (ARA-C), bleomycin (BLEO), 6-thioguanine (6-TG), methotrexate (MTX), 6-mercaptopurine (6-MP)

MIME

mitoguazon, ifosfamide (IFF), methotrexate (MTX), etoposide (VP-16)

MINE

MESNA, ifosfamide (IFF), mitoxantrone (DHAD), etoposide (VP-16)

MIV

mitoxantrone (DHAD), ifosfamide (IFF), etoposide (VP-16)

NHL-BFM 86/90 (Berlin-
Frankfurt-
Munster study)

vincristine (VCR), doxorubicin (DOX), prednisone (Pred), cyclophosphamide (CTX), dexamethasone (DEX), etoposide (VP-16), cytarabine (ARA-C), methotrexate (MTX), vindesine, ifosfamide (IFF)

POG 8106 (Pediatric Oncology Group)

high-dose methotrexate (MTX), high-dose cyclophosphamide (CTX), vincristine (VCR), prednisone (Pred)

 

PROMACE
-cytaBOM

prednisone (Pred), Adriamycin (doxorubicin; DOX), cyclophosphamide (CTX), etoposide (VP-16), cytarabine (ARA-C), bleomycin (BLEO), Oncovin (vincristine; VCR), methotrexate (MTX), leucovorin (Leu)

PROMACE/
MOPP

prednisone (Pred), methotrexate (MTX), Adriamycin (doxorubicin; DOX), cyclophosphamide (CTX), etoposide (VP-16), mustargen, Oncovin (vincristine; VCR), procarbazine (PCB)

VACOP-B

etoposide (VP-16), Adriamycin (doxorubicin; DOX), cyclophosphamide (CTX), Oncovin (vincristine; VCR), prednisone (Pred), bleomycin (BLEO)

VIM

etoposide (VP-16), ifosfamide (IFF), mitoxantrone (DHAD), prednisone (Pred)

VIM-Bleo

etoposide (VP-16), ifosfamide (IFF), methotrexate (MTX), bleomycin (BLEO)

 

Common drug names and abbreviations

Listed below in alphabetic order are drug names, abbreviations, their trade names, and modes of action.

Generic name, abbreviation

®Trade names

Mode of action and comments

Allopurinol

Lopurin Zyloprim

Rescue drug used to protect kidneys from certain chemotherapeutic drugs

9-aminocamp-
tothecin (9-AC)

(still in clinical trials)

See Camptothecin

Asparaginase (l-asparaginase (A-ase)

Elspar Oncaspar

Antimetabolite

Bleomycin (BLEO)

Blenoxane

Idiosyncratic agent; joins with one form of iron, breaking DNA strands

Busulfan (BU)

Myleran

Alkylating agent

Camptothecin (CPT11)

(still in clinical trials)

Topoisomerase inhibitor; a plant-derived alkaloid

Carmustine; nitrosurea (BCNU)

BiCNU or Gliadel

Alkylating agent

Chlorambucil (Chl)

Leukeran

Alkylating agent

2-chlorodeoxy-
adenosine (2-CDA)

Cladribine

Antimetabolite

Cisplatin (CDDP)

Platinol

Idiosyncratic alkylating agent

Cyclophospha-
mide (CTX)

Cytoxan or Neosar

Alkylating agent

 

Cytarabine or cytosine arabinoside (ARA-C)

Cytosar-U, Depo-Cyt, Tarabine

Antimetabolite

Cytoxan®

 

See cyclophosphamide

Dacarbazine (DTIC)

DTIC-Dome

Alkylating agent

Daunorubicin or daunomycin (DNR)

Cerubidine or DaunoXome

Topoisomerase inhibitor

Dexamethasone (DEX)

Decadron, Decaspray, Aeroseb-Dex, Hexadrol

Immunosuppressive agent

Doxorubicin (DOX)

Adriamycin, Doxil, Rubex

Topoisomerase inhibitor

Erythropoietin, Epoietin alfa (EPO)

Epogen, Procrit

Biological therapy; stimulates formation of red blood cells

Etoposide (VP-16)

Toposar, VePesid

Topoisomerase inhibitor

Filgrastim (G-CSF)

Neupogen

See Granulocyte colony stimulating factor

Fludarabine (FLUD)

Fludara

Antimetabolite

5-fluorouracil (5-FU)

Adrucil, Efudex, Fluoroplex

Idiosyncratic agent

Granulocyte colony stimulating factor (G-CSF)

Neupogen

Biological therapy; stimulates growth of white blood cells

 

Granulocyte-macrophage colony stimulating factor (GM-CSF)

Leukine

Biological therapy; stimulates growth of white blood cells and macrophages

Hydrocortisone
(HC)

A-hydroCort, Cortef, Hydrocortone Hytone, Locoid, Pandel, Solu-Cortef, Westcort

Immune suppressant

Hydroxorubicin

Adriamycin

See doxorubicin

Hydroxyurea (HU)

Droxia, Hydrea

Antimetabolite

Idarubicin (IDA)

Idamycin

Topoisomerase inhibitor

Ifosfamide (IFF)

Ifex

Alkylating agent

Interferon (IFN)s

Roferon A, Intron A, Alferon N

Biological therapies

Interleukin-2 (IL-2)

 

Biological therapy

Irinotecan

Camptosar

Topoisomerase inhibitor (soluble metabolite of camptothecin)

Leucovorin (Leu)

Wellcovorin

Rescue drug

Lomustine (CCNU)

CeeNU

Alkylating agent

Mechloreth-
amine, Nitrogen Mustard, (HN2)

Mustargen

Alkylating agent

Melphalan

Alkeran

Alkylating agent

Mercaptopurine
(6-MP)

Purinethol

Antimetabolite

Methotrexate or amethopterin(MTX)

Methotrexate

Antimetabolite

Methylpredniso-
lone (SOL)

Medrol, A-methaPred, Depo-Medrol, Solu-Medrol, SOL

Immune suppressant

Mitoguazone, methyl-GAG, methylglyoxal (bis)-
guanylhydrozan

(still in clinical trials)

Inhibitor of polyamine biosynthesis

Mitoxantrone (DHAD)

Novantrone

Topoisomerase inhibitor

Monoclonal antibody (mab, moab)

Rituxan, Bexxar

Biologic therapy; manmade copy of protein secreted by white blood cell to attack invading organisms

Nitrosurea

 

See Carmustine

Pentostatin or deoxycofor-
mycin

Nipent

Antimetabolite

Phosphocholine or hexadecylphos-
phocholine

Phosphocol P32

Antimetabolite

Prednisone (Pred)

Deltasone®, Orasone®, Prednisone

Immune suppressant

 

Prednisolone

Econopred, Hydeltrasol, Inflamase, Pediapred, Pred Forte, Pred Mild, Prelone

Immune suppressant

Procarbazine (PCB)

Matulane

Alkylating agent

Psoralen

methoxsalen

UV therapy; embeds in DNA, making it more sensitive to UVA light

Rituxan

See monoclonal antibody

Biological therapy

Sargramostim (GM-CSF)

Leukine

See granulocyte-macrophage colony stimulating factor

Teniposide (VM-26)

Vumon

Topoisomerase inhibitor

Thioguanine (6-TG)

 

Antimetabolite

Thrombopoietin (TPO)

(still in clinical trials)

Biological therapy; manmade copy of a natural body substance that stimulates the production of platelets

Topotecan

Hycamtin

Topoisomerase inhibitor (soluble metabolite of camptothecin)

Tumor necrosis factor (TNF)

(still in clinical trials)

Biological therapy; manmade copy of a natural body substance that exhibits antiviral and antitumor activity

Vinblastine (VLB)

Velban, Vinblastine

Vinca alkaloid; tubulin binding agent

Vincristine (VCR)

Oncovin

Vinca alkaloid; tubulin binding agent

Vindesine (VDS)

 

Vinca alkaloid; tubulin binding agent

Vinorelbine

Navelbine

Vinca alkaloid; tubulin binding agent



Resources

Clinical Pharmacology Online:
http://www:cponline.gsm.com/

RxList: http://www.rxlist.com/

PharmInfoNet: http://pharminfo.com

Glaxo Wellcome's DoseCalc: http://www.meds.com/DChome.html


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