cyclophosphamide + fludarabine + interleukin-2

This is a combination regimen consisting of three agents: - Cyclophosphamide, an alkylating agent that crosslinks DNA and inhibits cell replication. - Fludarabine, a purine analog antimetabolite that interferes with DNA synthesis and repair. - Interleukin-2 (IL-2), a cytokine that stimulates the proliferation and activation of lymphocytes, particularly T cells. The combination is primarily used as part of lymphodepleting chemotherapy regimens to prepare patients for adoptive cell therapies such as tumor-infiltrating lymphocyte (TIL) therapy or CAR-T cell therapy. The goal is to reduce endogenous immune cells (lymphodepletion) to enhance the engraftment, expansion, and efficacy of infused therapeutic immune cells. IL-2 may be added post-cell infusion to further stimulate T-cell proliferation and activity. This regimen has been studied in hematologic malignancies like chronic lymphocytic leukemia/indolent lymphoma[1], as well as in solid tumors such as metastatic melanoma in the context of TIL therapy[4][5]. The addition of IL-2 does not appear to significantly mitigate immunosuppression from fludarabine/cyclophosphamide but may support adoptive cell therapies.