rituximab + lenalidomide + etoposide + methotrexate + vincristine + doxorubicin + cyclophosphamide + prednisone

rituximab + lenalidomide + etoposide + methotrexate + vincristine + doxorubicin + cyclophosphamide + prednisone (often abbreviated as R-L-MECHOP) is an intensified chemoimmunotherapy regimen developed for the treatment of newly diagnosed diffuse large B-cell lymphoma (DLBCL). This combination therapy, primarily investigated by The Affiliated Hospital of Xuzhou Medical University, builds upon the standard R-CHOP backbone by incorporating the immunomodulatory agent lenalidomide, the topoisomerase inhibitor etoposide, and the antimetabolite methotrexate. The regimen is designed to enhance anti-tumor activity through multiple mechanisms: rituximab targets CD20-positive B-cells; lenalidomide modulates the cereblon E3 ligase complex to induce degradation of transcription factors like Ikaros and Aiolos; and the MECHOP chemotherapy components provide broad-spectrum cytotoxicity by inhibiting DNA synthesis, inducing DNA damage, and disrupting mitotic spindles. The inclusion of methotrexate also serves as prophylaxis against central nervous system involvement, which is a significant risk in high-grade DLBCL.

Other names

R-L-MECHOP regimenLenalidomide plus R-MECHOPR-MECHOP-L