vinorelbine + ifosfamide + prednisone + vincristine + rituximab

This regimen is an investigational multi-agent chemotherapy and immunotherapy combination comprising the vinca alkaloids vinorelbine and vincristine, the alkylating agent ifosfamide, the corticosteroid prednisone, and the anti-CD20 monoclonal antibody rituximab, used experimentally in B‑cell lymphomas. Vinorelbine and vincristine disrupt microtubule assembly and inhibit mitosis, ifosfamide alkylates DNA and induces crosslinks leading to apoptosis, prednisone exerts lympholytic and anti-inflammatory effects via glucocorticoid receptor activation, and rituximab targets CD20 on B lymphocytes to mediate complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, and direct apoptotic signaling. The combination is designed to provide broad cytotoxic coverage of rapidly dividing lymphoma cells together with targeted depletion of CD20-positive B cells, but it is not a standard named regimen and has primarily been used in protocolized or exploratory settings for aggressive or relapsed/refractory B‑cell lymphomas.