rituximab + etoposide + cyclophosphamide + doxorubicin + vincristine + prednisone + filgrastim

This is a multi-agent chemotherapy and immunotherapy regimen combining the monoclonal antibody rituximab with the cytotoxic agents etoposide, cyclophosphamide, doxorubicin, vincristine, and the corticosteroid prednisone. Filgrastim (granulocyte colony-stimulating factor; G-CSF) is included to reduce neutropenia by stimulating white blood cell production. This combination is primarily used for aggressive B-cell non-Hodgkin lymphomas such as diffuse large B-cell lymphoma (DLBCL) and primary mediastinal large B-cell lymphoma (PMLBL), especially in regimens like dose-adjusted EPOCH-R (DA-EPOCH-R). Rituximab targets CD20 on B cells leading to their destruction via immune-mediated mechanisms. The chemotherapeutic agents act through various mechanisms including DNA intercalation, inhibition of topoisomerase II (etoposide), alkylation of DNA (cyclophosphamide), inhibition of microtubule formation (vincristine), and free radical generation causing DNA damage (doxorubicin). Prednisone induces apoptosis in lymphoid cells. Filgrastim acts as a recombinant human G-CSF to stimulate neutrophil proliferation and differentiation[1][3][4][8].

Other names

R-EPOCH plus filgrastimDA-EPOCH-R plus G-CSF