thalidomide + celecoxib + fenofibrate + etoposide + cyclophosphamide

This 5-drug oral metronomic chemotherapy regimen was developed by the Dana-Farber Cancer Institute for the treatment of relapsed or progressive pediatric cancers. The regimen consists of thalidomide, celecoxib, fenofibrate, etoposide, and cyclophosphamide. Unlike traditional high-dose chemotherapy, this regimen utilizes low-dose, frequent (metronomic) administration to target tumor angiogenesis (the formation of new blood vessels) and the tumor microenvironment, while also exerting direct cytotoxic effects on proliferating cancer cells. Cyclophosphamide and etoposide act as DNA-damaging agents, while thalidomide, celecoxib (a COX-2 inhibitor), and fenofibrate (a PPAR-alpha agonist) contribute to the anti-angiogenic effect. This combination is specifically evaluated in children and young adults with various refractory malignancies, including leukemia, lymphoma, and various central nervous system and solid tumors.

Other names

5-drug oral anti-angiogenic regimenDana-Farber metronomic regimenDFCI 5-drug regimenDFCI5-drug regimenDFCI-5-drug regimen