prednisone + etoposide + procarbazine + cyclophosphamide

PEPC is an all-oral metronomic chemotherapy regimen consisting of prednisone, etoposide, procarbazine, and cyclophosphamide. Unlike traditional high-dose chemotherapy, PEPC is administered at low, frequent doses to achieve anti-angiogenic and immunomodulatory effects, aiming to suppress tumor growth by targeting the tumor microenvironment and vascularization rather than relying solely on direct cytotoxicity. This regimen is primarily investigated for the treatment of relapsed or refractory lymphomas, such as mantle cell lymphoma (MCL) and diffuse large B-cell lymphoma (DLBCL). It is frequently combined with other agents, such as rituximab and thalidomide (forming the RT-PEPC regimen), to enhance efficacy in heavily pretreated patients while maintaining a manageable toxicity profile.

Other names

PEPC regimenmetronomic PEPCPEP-C