l-asparaginase + dexamethasone + ifosfamide + etoposide + cisplatin

L-DICE (also known as DICE-L) is a multi-agent combination chemotherapy regimen developed by Fudan University (Shanghai Cancer Center) for the treatment of extranodal natural killer/T-cell lymphoma (ENKTL), nasal type. The regimen consists of the biologic enzyme L-asparaginase and four small molecule agents: dexamethasone, ifosfamide, cisplatin, and etoposide. L-asparaginase acts by depleting circulating L-asparagine, which lymphoma cells cannot synthesize, leading to metabolic stress and apoptosis. Ifosfamide and cisplatin are DNA-alkylating and crosslinking agents that disrupt DNA replication, while etoposide inhibits topoisomerase II. Dexamethasone is a corticosteroid that provides lympholytic activity. This regimen has been primarily studied in Phase II clinical trials (e.g., NCT00933673) for patients with previously untreated Stage I/II ENKTL, often followed by intensity-modulated radiation therapy (IMRT).

Other names

L-asparaginase plus DICEL-asparaginase + dexamethasone + ifosfamide + etoposide + cisplatin