gemcitabine + l-asparaginase + ifosfamide + dexamethasone + etoposide

This is a multi-agent chemotherapy combination consisting of five drugs—gemcitabine, l-asparaginase, ifosfamide, dexamethasone, and etoposide—used primarily in the treatment of aggressive lymphoid malignancies such as extranodal NK/T-cell lymphoma and peripheral T-cell lymphomas (PTCLs). Each component has a distinct mechanism: - Gemcitabine is a nucleoside analog that inhibits DNA synthesis. - L-asparaginase depletes asparagine, an amino acid essential for certain tumor cells. - Ifosfamide is an alkylating agent causing DNA crosslinking and cell death. - Dexamethasone is a synthetic glucocorticoid with anti-inflammatory and cytotoxic effects on lymphoid cells. - Etoposide inhibits topoisomerase II, leading to DNA strand breaks. The regimen was developed to overcome multidrug resistance seen in these cancers by combining agents not affected by P-glycoprotein-mediated efflux. The combination has been used both for newly diagnosed and relapsed/refractory cases. In some institutions it is referred to as the "PIGLETS" regimen[2][4]. Clinical studies report encouraging response rates with generally tolerable side effects[2].

Other names

PIGLETS regimen