nivolumab + etoposide + prednisolone + vincristine + cyclophosphamide + doxorubicin

The combination of nivolumab with the dose-adjusted EPOCH chemotherapy regimen (etoposide, prednisolone, vincristine, cyclophosphamide, and doxorubicin) is an experimental chemoimmunotherapy being evaluated as a first-line treatment for peripheral T-cell lymphoma (PTCL). Nivolumab is a human monoclonal antibody that acts as an immune checkpoint inhibitor by binding to the programmed death-1 (PD-1) receptor, thereby preventing its interaction with ligands PD-L1 and PD-L2 and restoring the anti-tumor activity of T-cells. The EPOCH backbone provides multi-targeted cytotoxic effects: etoposide and doxorubicin (hydroxydaunorubicin) inhibit DNA topoisomerase II; cyclophosphamide acts as a DNA alkylating agent; vincristine (Oncovin) disrupts microtubule formation by binding to tubulin; and prednisolone is a glucocorticoid that induces apoptosis in malignant lymphoid cells. This integrated approach, led by the University of Colorado, Denver, aims to overcome the chemoresistance often seen in PTCL and improve clinical outcomes compared to standard chemotherapy alone.

Brand names

OpdivoOncovinAdriamycinCytoxanVepesid

Other names

hydroxydaunorubicin-University of Colorado, Denver-peripheral T-cell lymphomaNivolumab plus dose-adjusted EPOCH