R-CHOP with methotrexate

This is a combination chemotherapy regimen that includes rituximab (a monoclonal antibody), multiple chemotherapy drugs (cyclophosphamide, doxorubicin, vincristine, methotrexate), and a steroid (prednisone). The combination is used primarily for treating various types of lymphomas, particularly B-cell lymphomas. The canonical name for this combination would be "R-CHOP with methotrexate" or "R-CHOP-M", as it builds upon the standard R-CHOP regimen with the addition of methotrexate. This combination is specifically designed to enhance treatment efficacy, particularly for patients with certain types of lymphoma that may have a higher risk of central nervous system (CNS) involvement. The regimen works through multiple mechanisms: rituximab targets CD20-positive B cells, while the chemotherapy drugs attack cancer cells through different pathways, and prednisone helps reduce inflammation and enhances the effectiveness of the other drugs. The addition of methotrexate, particularly high-dose methotrexate, provides better CNS penetration to prevent or treat CNS involvement in lymphoma. According to the search results, this combination has been studied in clinical trials for intravascular large B-cell lymphoma (IVLBCL) and other aggressive B-cell lymphomas. The PRIMEUR-IVL trial specifically evaluated R-CHOP with high-dose methotrexate and intrathecal chemotherapy for patients with previously untreated IVLBCL[3]. Treatment typically consists of multiple cycles, with R-CHOP given every 21 days (3 weeks) or sometimes every 14 days (2 weeks), and methotrexate administered at specific points in the treatment schedule. The exact protocol may vary depending on the specific type of lymphoma and individual patient factors. The combination has shown promising results in clinical trials, with the PRIMEUR-IVL trial reporting a 2-year progression-free survival of 76% for patients with IVLBCL[3]. Common side effects include neutropenia, leucocytopenia, and other hematologic toxicities. This regimen represents a CNS-oriented therapy approach for lymphomas with higher risk of CNS involvement, combining the established efficacy of R-CHOP with the CNS-penetrating properties of methotrexate.

Other names

R-CHOP-M