temozolomide + vinblastine + cisplatin + interleukin-2 + interferon alpha

Concurrent decrescendo biochemotherapy is an intensive multi-agent treatment regimen developed at Duke University for the treatment of advanced or metastatic melanoma. The regimen combines traditional cytotoxic chemotherapy agents—cisplatin, vinblastine, and temozolomide—with the immunomodulatory cytokines interleukin-2 (IL-2) and interferon alpha. The term decrescendo specifically refers to the tapering dose of IL-2 administered over the course of the treatment cycle (e.g., 18, 9, and 4.5 MIU/m²), a strategy designed to mitigate the severe toxicities associated with high-dose IL-2, such as capillary leak syndrome, while maintaining therapeutic efficacy. This regimen was often evaluated as part of a chemo-switch strategy, where induction with intensive biochemotherapy is followed by maintenance therapy with low-dose temozolomide and sorafenib.

Other names

Concurrent decrescendo biochemotherapyCDB regimenDuke biochemotherapy regimenConcurrent decrescendo biochemotherapy-Duke University-melanoma