cyclophosphamide + vincristine + doxorubicin liposomal + prednisone + rituximab

This is a combination chemotherapy regimen used primarily for the treatment of non-Hodgkin lymphoma and other aggressive B-cell lymphomas. It consists of five drugs: - **Cyclophosphamide** (an alkylating agent that crosslinks DNA, leading to cell death) - **Vincristine** (a vinca alkaloid that inhibits microtubule formation, arresting mitosis) - **Doxorubicin liposomal** (an anthracycline antibiotic encapsulated in liposomes to reduce toxicity and improve delivery; it intercalates DNA and inhibits topoisomerase II) - **Prednisone** (a corticosteroid with anti-inflammatory and immunosuppressive effects, also cytotoxic to certain cancer cells) - **Rituximab** (a monoclonal antibody targeting CD20 on B-cells, leading to their destruction via immune-mediated mechanisms). The substitution of conventional doxorubicin with its pegylated liposomal formulation aims to reduce cardiotoxicity while maintaining efficacy. This regimen is an alternative to standard R‑CHOP in patients where reduced cardiac toxicity is desired or required[4].

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