R-CHOP Cancer Treatment

R-CHOP is an acronym that represents a commonly used combination chemotherapy regimen in cancer treatment.

R-CHOP consists of the following drugs:

• Rituximab (Rituxan)
• Cyclophosphamide
• Hydroxyldaunorubicin (doxorubicin)
• Oncovin (vincristine)
• Prednisone

A Typical R-CHOP Regimen

(regimens should be tailored to the individual)

• Cycle length: 21 days
• Number of cycles: 6-8
• Day 1: Cyclophosphamide and Rituxan (IV); doxorubicin and vincristine (IV push)
• Days 1-5: Prednisone (oral)

Vomit potential?

Moderately high

R-CHOP is one of the most widely used combination chemotherapy regimens in the sphere of B-cell non-Hodgkin's lymphoma since studies first began to combine the newer monoclonal antibody Rituxan with the CHOP regimen around 2005. Typically R-CHOP follows a 21-day cycle, although sometimes oncologists will use a more intense 14-day cycle.

What R-CHOP is effective for and why

In 2006, the FDA approved R-CHOP as a first-line treatment for patients with diffuse large B-cell, CD20-positive, non-Hodgkin's lymphoma (DLBCL). Since then, R-CHOP has been used in the effective treatment of a wide range of B-cell NHL subtypes, including follicular lymphoma, mantle cell lymphoma, Burkitt's lymphoma, primary mediastinal large B-cell lymphoma, primary cutaneous B-cell lymphoma, and primary central nervous system lymphoma, to name a few.

Side effects

While each patient will have his or her own experiences with the side effects of the R-CHOP regimen, it is not uncommon for patients to endure mouth sores, nausea and/or vomiting, susceptibility to infections, hair loss, fatigue, and in some cases, peripheral neuropathy. These side effects should all subside when one is finished with the regimen. Patients are encouraged to report all side effects to their oncologist or oncology team.

Sources

• Boyiadzis, Michael M. et al. Hematology-Oncology Therapy. 2007. New York: McGraw Hill, Medical Publishing Division.
• Chemotherapy Drugs 101: The R-CHOP regimen
• Cancerackup UK: R-CHOP

Significant studies relating to R-CHOP

• Feugier P et al. "Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d'Etude des Lymphomes de l'Adulte." J Clin Oncol. 2005 Jun 20;23(18):4117-26. Epub 2005 May 2.
• Pfreundschuh M et al. "CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group." Lancet Oncol. 2006 May;7(5):379-91.
• Sehn LH et al. "The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP." Blood. 2007 Mar 1;109(5):1857-61.
• Winter JN et al. "Expression of p21 protein predicts clinical outcome in DLBCL patients older than 60 years treated with R-CHOP but not CHOP: a prospective ECOG and Southwest Oncology Group correlative study on E4494." Clin Cancer Res. 2010 Apr 15;16(8):2435-42. Epub 2010 Apr 6.