rituximab + methotrexate + thiotepa + etoposide + cytarabine

This is a combination regimen consisting of five drugs: **rituximab** (a monoclonal antibody against CD20), **methotrexate** (an antimetabolite chemotherapy agent inhibiting dihydrofolate reductase), **thiotepa** (an alkylating agent), **etoposide** (a topoisomerase II inhibitor), and **cytarabine** (a nucleoside analog antimetabolite). These agents are used together in certain high-intensity protocols for the treatment of aggressive lymphomas with central nervous system (CNS) involvement, such as **diffuse large B-cell lymphoma (DLBCL)** with secondary CNS spread and primary CNS lymphoma. This extended regimen is based on the MATRix regimen (rituximab, methotrexate, thiotepa, cytarabine), with etoposide added as part of a sequential protocol (e.g., MATRix followed by RICE, where RICE includes rituximab, ifosfamide, carboplatin, etoposide)[2]. The combination leverages different mechanisms: targeting malignant B-cells, disrupting DNA synthesis and repair, and overcoming the blood-brain barrier for CNS penetration.

Other names

RMT-EA regimenRMT-EA protocol