From the Guidelines
R-CHOP is a combination chemotherapy regimen used primarily to treat non-Hodgkin lymphoma, especially diffuse large B-cell lymphoma, and its components include Rituximab, Cyclophosphamide, Hydroxydaunorubicin (also known as doxorubicin), Oncovin (also known as vincristine), and Prednisone. The components of R-CHOP include five medications:
- Rituximab (R), which is a monoclonal antibody targeting CD20 on B cells
- Cyclophosphamide (C), an alkylating agent that damages DNA
- Hydroxydaunorubicin (H), also known as doxorubicin, an anthracycline that intercalates DNA and inhibits topoisomerase II
- Oncovin (O), also known as vincristine, a plant alkaloid that disrupts microtubules
- Prednisone (P), a corticosteroid that reduces inflammation and has direct lympholytic effects. The regimen is typically administered in 21-day cycles, with rituximab, cyclophosphamide, doxorubicin, and vincristine given intravenously on day 1, while prednisone is taken orally on days 1-5, as recommended by the most recent guidelines 1. Standard dosing includes rituximab 375 mg/m², cyclophosphamide 750 mg/m², doxorubicin 50 mg/m², vincristine 1.4 mg/m² (capped at 2 mg), and prednisone 100 mg daily for 5 days, with most patients receiving 6-8 cycles of treatment, and regular monitoring of blood counts, cardiac function, and treatment response throughout therapy 1. It is essential to note that treatment strategies should be stratified according to age, IPI, and feasibility of dose-intensified approaches, and that the inclusion in a clinical trial is recommended whenever available 1. Dose reductions due to haematological toxicity should be avoided, and febrile neutropaenia justifies prophylactic use of haematopoietic growth factors in patients treated with curative intent and in patients older than 60 years of age 1. In cases with high tumour load, precautions such as the administration of prednisone several days as ‘prephase’ treatment are advised to avoid tumour lysis syndrome 1.
From the FDA Drug Label
The safety and effectiveness of RITUXAN were evaluated in three randomized, active-controlled, open-label, multicenter studies with a collective enrollment of 1854 patients Patients with previously untreated diffuse large B-cell NHL received RITUXAN in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or other anthracycline-based chemotherapy regimens Patients received 6 or 8 cycles of CHOP, each cycle lasting 21 days All patients in the R-CHOP arm received 4 doses of RITUXAN 375 mg/m2 on Days –7 and –3 (prior to Cycle 1) and 48–72 hours prior to Cycles 3 and 5. Patients who received 8 cycles of CHOP also received RITUXAN prior to Cycle 7.
The components of R-CHOP therapy for lymphoma are:
- Rituximab
- Cyclophosphosphate (cyclophosphamide)
- Hydroxydaunorubicin (doxorubicin)
- Oncovin (vincristine)
- Prednisone 2
From the Research
Components of R-CHOP Therapy
The components of R-CHOP therapy for lymphoma are:
- Rituximab: an anti-CD20 monoclonal antibody 3, 4, 5, 6, 7
- Cyclophosphicide: an alkylating agent 3, 4, 5, 6, 7
- Hydroxydaunorubicin (doxorubicin): an anthracycline antibiotic 3, 4, 5, 6, 7
- Oncovin (vincristine): a vinca alkaloid 3, 4, 5, 6, 7
- Prednisone: a corticosteroid 3, 4, 5, 6, 7
Administration of R-CHOP Therapy
R-CHOP therapy can be administered in various ways, including:
- Every 21 days for 6-8 cycles 4, 6
- Every 14 days for 6 cycles, followed by two further infusions of rituximab 4
- With high-dose methotrexate and intrathecal chemotherapy for patients with intravascular large B-cell lymphoma 7
Patient Population
R-CHOP therapy can be used to treat various types of lymphoma, including: