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R-CHOP is a combination chemotherapy regimen consisting of five drugs: cyclophosphamide (an alkylating agent), doxorubicin (an anthracycline antibiotic), vincristine (a vinca alkaloid), prednisone (a corticosteroid), and rituximab (a monoclonal antibody targeting CD20). This regimen is primarily used as first-line therapy for B-cell non-Hodgkin lymphomas such as diffuse large B-cell lymphoma (DLBCL) and advanced follicular lymphoma. Each component acts via a different mechanism to kill cancer cells or modulate the immune response. Cyclophosphamide crosslinks DNA leading to cell death; doxorubicin intercalates DNA and inhibits topoisomerase II; vincristine disrupts microtubule formation inhibiting mitosis; prednisone induces apoptosis in certain cancerous lymphocytes by modulating gene expression through the glucocorticoid receptor; rituximab binds CD20 on B-cells leading to their destruction via immune-mediated mechanisms[2][3][7].
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