oxaliplatin + fludarabine + cytarabine + rituximab

A multi-agent chemotherapy-immunotherapy regimen combining the platinum analog oxaliplatin, the purine analog fludarabine, the antimetabolite cytarabine (Ara-C), and the anti-CD20 monoclonal antibody rituximab. Mechanistically, oxaliplatin forms DNA crosslinks causing apoptosis; fludarabine inhibits DNA synthesis via ribonucleotide reductase/DNA polymerase inhibition and is synergistic with cytarabine, which is phosphorylated to Ara-CTP and inhibits DNA polymerase and chain elongation; rituximab binds CD20 on B cells and mediates B-cell depletion via complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, and direct apoptosis. This combination has been explored primarily in relapsed/refractory B-cell lymphoid malignancies (e.g., non-Hodgkin lymphoma, CLL) where rituximab targets CD20-positive cells while chemotherapy provides cytotoxic backbone. Rituximab is FDA-approved with chemotherapy for multiple B‑cell malignancies, including pediatric advanced-stage mature B‑cell NHL/acute leukemia; oxaliplatin, fludarabine, and cytarabine are individually approved agents in oncology.

Other names

OFAROFAR-Roxaliplatin fludarabine cytarabine rituximab combination regimen