What are the results of the CAPE (Cyclophosphamide, Doxorubicin, Etoposide) ESCAPE treatment protocol?

Results of the CAPE (Cyclophosphamide, Doxorubicin, Etoposide) ESCAPE Treatment Protocol

The CAPE (Cyclophosphamide, Doxorubicin, Etoposide) ESCAPE treatment protocol is not a recognized standard regimen in current oncology practice guidelines for any specific cancer type.

Understanding Drug Combinations in Oncology

• Cyclophosphamide, doxorubicin, and etoposide are commonly used chemotherapeutic agents that appear in various established regimens for different malignancies 1.
• These agents are frequently used in combination regimens for treating lymphomas, sarcomas, and small cell lung cancer, but not under the specific name "CAPE ESCAPE" 1.

Similar Established Regimens

For Ewing Sarcoma:

• Current first-line treatment protocols for Ewing sarcoma include combinations of vincristine (V), doxorubicin (D), cyclophosphamide (C), ifosfamide (I), and etoposide (E) 1.
• The interval-compressed VDC/IE regimen (vincristine, doxorubicin, cyclophosphamide alternating with ifosfamide and etoposide) has shown superior results compared to other regimens and is currently the preferred first-line treatment 1.
• This regimen has demonstrated improved survival rates of 60-70% in localized disease and 20-40% in metastatic disease 1.

For Lymphomas:

• For diffuse large B-cell lymphoma (DLBCL), the standard regimen is R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) 1.
• More intensive regimens like EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin) with rituximab are used in specific circumstances 1.
• For HIV-associated plasmablastic lymphoma, regimens containing cyclophosphamide, doxorubicin, and etoposide have been used with varying success 1.

For Small Cell Lung Cancer:

• Historical data shows combinations of these agents (like PACE - platinum, doxorubicin, cyclophosphamide, and etoposide) have been studied for small cell lung cancer with complete response rates of 53% for limited disease and 37-44% for extensive disease 2.

Potential Confusion with ESCAPE Trial

• The term "ESCAPE" in medical literature most prominently refers to the Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with Emphasis on minimizing CT to recanalization times trial, which is an endovascular stroke treatment study unrelated to cancer therapy 3.

Potential Side Effects of These Agents

• Common side effects of these chemotherapeutic agents include:
  • Myelosuppression (low blood counts) 4
  • Cardiac toxicity (particularly with doxorubicin) 1
  • Risk of secondary malignancies 1
  • Nausea, vomiting, and hair loss 5, 4
  • Potential for cardiac arrhythmias 1

Conclusion

• There is no standardized chemotherapy regimen specifically called "CAPE ESCAPE" in current oncology practice guidelines.
• The combination of cyclophosphamide, doxorubicin, and etoposide is used in various established protocols for different malignancies, particularly in sarcomas and lymphomas, but under different regimen names 1, 5.
• If you are seeking information about a specific treatment protocol, consulting with the treating oncologist for clarification is recommended.