methotrexate + doxorubicin + dexamethasone + cyclophosphamide + polatuzumab vedotin

MAD CP is a multi-agent chemotherapy and targeted immunotherapy regimen being evaluated in the Phase 2 RADICAL clinical trial (NCT04734132), sponsored by New York Medical College. The regimen is specifically designed for children, adolescents, and young adults (CAYA) with newly diagnosed mature B-cell non-Hodgkin lymphoma (MB-NHL) or classical Hodgkin lymphoma (cHL). It combines a reduced-toxicity chemotherapy backbone—consisting of high-dose methotrexate, doxorubicin (Adriamycin), dexamethasone, and cyclophosphamide—with polatuzumab vedotin, an antibody-drug conjugate (ADC) targeting CD79b. The goal of the regimen is to maintain high disease control while minimizing long-term toxicities associated with high-dose anthracyclines and radiation exposure. Polatuzumab vedotin delivers the microtubule-disrupting agent monomethyl auristatin E (MMAE) directly to B-cells, while the chemotherapy components provide systemic cytotoxic effects through DNA alkylation, intercalation, and metabolic inhibition.

Other names

RADICAL MAD CP regimen