Chemotherapy regimen

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]

Nomenclature

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
CVE	carboplatin, vincristine, etoposide	retinoblastoma
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 (MAGIC)	epirubicin, cisplatin, fluorouracil (5-FU)	gastric cancer and cancer of the esophagogastric junction (Siewert classification III)
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
FCR	fludarabine, cyclophosphamide, 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
FEC-T	fluorouracil (5-FU), epirubicin, cyclophosphamide together, followed by docetaxel (Taxotere)	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[citation needed]	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
FLOT	fluorouracil (5-FU), leucovorin (folinic acid), oxaliplatin, docetaxel	esophageal cancer, gastric cancer
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	bladder cancer
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
IVA	ifosfamide, vincristine, actinomycin D	rhabdomyosarcoma
MAP or MAPIE	Doxorubicin (Adriamycin), Cisplatin, Methotrexate, Ifosfamide (Ifex), Etoposide (Vepesid)	Bone cancer, Osteosarcoma
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, doxorubicin (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
platin + taxane[5]	cisplatin/carboplatin, paclitaxel/docetaxel	ovarian cancer
POMP	6-mercaptopurine (Purinethol), vincristine (Oncovin), methotrexate, and prednisone	acute adult leukemia[6]
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[7]
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	docetaxel (Taxotere), carboplatin, trastuzumab (Herceptin)	breast cancer with positive HER2/neu receptor
TCHP	docetaxel (Taxotere), carboplatin, trastuzumab (Herceptin), pertuzumab (Perjeta)	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[8]	Wilms' tumor[8]
DD-4A	vincristine, actinomycin, doxorubicin (Adriamycin)[8]	Wilms' tumor[8]
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[8]
VAPEC-B	vincristine, doxorubicin (Adriamycin), prednisone, etoposide, cyclophosphamide, bleomycin	Hodgkin's lymphoma
VDC-IE	vincristine, doxorubicin, cyclophosphamide, ifosfamide, etoposide	Ewing's sarcoma
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)[9][10]	testicular cancer, germ cell tumors
VTD-PACE	bortezomib (Velcade), thalidomide, dexamethasone plus platinum agent, doxorubicin (Adriamycin), cyclophosphamide, etoposide	multiple myeloma
V-DCEP	bortezomib (Velcade), dexamethasone, cyclophosphamide, etoposide, platinum agent	relapsed or refractory multiple myeloma

See also

• National Comprehensive Cancer Network Treatment Guidelines
• Breast cancer chemotherapy
• High-dose chemotherapy
• Sequential high-dose chemotherapy

References

1. Mayer RJ (February 2009). "Targeted therapy for advanced colorectal cancer—more is not always better". N Engl J Med. 360 (6): 623–5. doi:10.1056/NEJMe0809343. PMID 19196680. letter commenting on the Clinical trial: Tol J, Koopman M, Cats A, Rodenburg CJ, Creemers GJ, Schrama JG, Erdkamp FL, Vos AH, van Groeningen CJ, Sinnige HA, Richel DJ, Voest EE, Dijkstra JR, Vink-Börger ME, Antonini NF, Mol L, van Krieken JH, Dalesio O, Punt CJ (February 2009). "Chemotherapy, bevacizumab, and cetuximab in metastatic colorectal cancer". N Engl J Med. 360 (6): 563–72. doi:10.1056/NEJMoa0808268. hdl:2066/79995. PMID 19196673.
2. Cancer.net - Explaining Maintenance Therapy
3. BEACOPP chemotherapy regimen
4. "MVAC Still the 'Best Treatment' for Advanced Bladder Cancer Patients. 1999". Archived from the original on 2012-01-09. Retrieved 2010-11-18.
5. "Ovarian Cancer Chemotherapy: Know Your Treatment Options".
6. Rodriguez Victorio (1973). "POMP combination chemotherapy of adult acute leukemia". Cancer. 32 (1): 69–75. doi:10.1002/1097-0142(197307)32:1<69::AID-CNCR2820320109>3.0.CO;2-0. PMID 4515259.
7. 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. S2CID 12851937.
8. Treatment of Wilms Tumor at National Cancer Institute. Last Modified: 03/29/2012
9. 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. S2CID 6362786.
10. 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.

External links

• Chemotherapy regimens and references
• Chemotherapy side effects Archived 2012-08-15 at the Wayback Machine
• Christie Hospital Chemotherapy Patient Information Sheets