rituximab + methotrexate + cytarabine + dexamethasone

This is a four-drug combination chemotherapy regimen consisting of rituximab (a monoclonal antibody targeting CD20), methotrexate (an antimetabolite and antifolate agent), cytarabine (an antimetabolite), and dexamethasone (a synthetic glucocorticoid). The combination is primarily used as first-line treatment for primary central nervous system lymphoma (PCNSL), particularly in immunocompetent patients. Rituximab targets the CD20 antigen on B-cells, leading to their destruction via immune-mediated mechanisms. Methotrexate inhibits dihydrofolate reductase, blocking DNA synthesis; cytarabine inhibits DNA polymerase, impairing DNA replication; and dexamethasone exerts anti-inflammatory and lympholytic effects. The addition of rituximab to the methotrexate-cytarabine-dexamethasone backbone has been shown to increase complete remission rates without significantly increasing serious toxicities[1][2][3][6].

Other names

RMAD regimenR-MAD regimen