prednisolone + etoposide + cyclophosphamide + methotrexate

PECM is a chemotherapy regimen primarily utilized for the treatment of extranodal natural killer/T-cell lymphoma (ENKTL), nasal type. The regimen is a combination of four distinct pharmacological agents: prednisolone (a corticosteroid), etoposide (a topoisomerase II inhibitor), cyclophosphamide (an alkylating agent), and methotrexate (an antimetabolite). Historically, PECM was employed as a front-line or salvage therapy for NK/T-cell lymphomas before the widespread adoption of L-asparaginase-based protocols. Its clinical efficacy is significantly limited by the high expression of P-glycoprotein (MDR1) in NK/T-cell lymphoma cells, which actively effluxes drugs like etoposide and vincristine, leading to multi-drug resistance. Consequently, modern treatment strategies have largely shifted toward regimens such as SMILE (dexamethasone, methotrexate, ifosfamide, L-asparaginase, and etoposide) or P-GEMOX (pegaspargase, gemcitabine, and oxaliplatin), which incorporate agents that bypass the P-glycoprotein-mediated resistance mechanism.

Other names

PECM regimenP-ECM