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FVD is a combination chemotherapy regimen consisting of fotemustine, teniposide, and dexamethasone, specifically developed for the treatment of newly diagnosed primary central nervous system lymphoma (PCNSL). The regimen was pioneered by Dr. Mingzhi Zhang at the First Affiliated Hospital of Zhengzhou University. It utilizes agents with high lipophilicity and the ability to cross the blood-brain barrier. Fotemustine is a third-generation chloroethylnitrosourea alkylating agent that targets DNA; teniposide is a podophyllotoxin derivative that inhibits DNA topoisomerase II; and dexamethasone is a corticosteroid used for its lymphocytotoxic effects and to reduce peritumoral edema. Clinical evaluations, including Phase 2 and Phase 4 trials, have compared FVD to standard high-dose methotrexate-based regimens, suggesting comparable efficacy with a distinct toxicity profile.
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