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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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