cyclosporine + pravastatin + mitoxantrone + etoposide

This is an investigational combination therapy regimen, often referred to as the CPME regimen, developed by the Fred Hutchinson Cancer Center for the treatment of relapsed or refractory acute myeloid leukemia (AML). The regimen integrates two chemosensitizing agents—cyclosporine and pravastatin—with the cytotoxic chemotherapy drugs mitoxantrone and etoposide. Cyclosporine acts as a multidrug resistance (MDR) modulator by inhibiting the P-glycoprotein (P-gp) efflux pump, which frequently expels chemotherapy from leukemia cells. Pravastatin, an HMG-CoA reductase inhibitor, is used to block the adaptive cholesterol synthesis and uptake mechanisms that AML cells utilize to survive cytotoxic stress. Mitoxantrone and etoposide are topoisomerase II inhibitors that induce DNA damage. By combining these agents, the regimen aims to overcome established resistance mechanisms and enhance the efficacy of standard chemotherapy in patients with difficult-to-treat AML.

Other names

CPME regimenCyclosporine/Pravastatin/Mitoxantrone/Etoposidecyclosporine-Fred Hutchinson Cancer Center-leukemia (acute myeloid)