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rituximab + cyclophosphamide, doxorubicin, vincristine, and prednisone

R-CHOP is the abbreviated name for the combination of drugs that is commonly used as chemotherapy for certain cancers, such as non-Hodgkin lymphomas, or NHLs.

The National Cancer Institute, or NCI, has a definition for R-CHOP that includes other names that may be used for the same drug:

“An immunochemotherapy regimen consisting of rituximab, cyclophosphamide, hydroxydaunorubicin hydrochloride (doxorubicin hydrochloride), vincristine (Oncovin) and prednisone used to treat both indolent and aggressive forms of non-Hodgkin lymphoma.”

The NCI also notes that this combination may also be used with other drugs or treatments or to treat other types of cancer. Patients may also be interested to know that individual constituents of R-CHOP, such as the rituximab alone, might be used in some instances to treat or manage certain malignancies in certain individuals.

More on R-CHOP

Indeed, as knowledge of the various types of lymphomas expands, scientists are learning that different subtypes of the same lymphoma may respond differently to a given regimen. Clinical trials are looking into the use of other agents, in combination with R-CHOP, for a variety of malignancies.

R-CHOP is considered a standard treatment for one of the most common types of NHL, diffuse large B-cell lymphoma, or DLBCL. When you look at NHL as a whole, DLBCL accounts for 25 to 35 percent of all new diagnoses globally each year. R-CHOP may also be used in certain cases of follicular lymphoma, according to the 2016 Guidelines from the National Comprehensive Cancer Network.

The particulars of the whole regimen, including and how many times each medication is given, over what period of time, and in what sequence, can vary depending on the malignancy, the patient’s response, and the doctors or institutions involved. One sequence of medications is referred to as a cycle, so you may hear doctors talking about “how many cycles of R-CHOP” are planned, for instance.

One protocol involves the administration of rituximab as an infusion over a few hours on the first day of treatment, while the drugs of the CHOP regimen may be started the next day. The entire course may be repeated every three weeks for some 6-8 cycles. However, today clinicians also speak of CHOP-like regimens, too, and there are a variety of different protocols doctors may follow that use these medications.

Something called “R - mini-CHOP” is being explored, for instance. The Groupe d'Etude des Lymphomes de l'Adulte (GELA) – a research group with a very French name -- examined the question of minimizing toxicity in people with DLBCL ages 80 to 95. They aimed to investigate the efficacy and safety of a decreased dose of CHOP (doxorubicin, cyclophosphamide, vincristine, and prednisone) chemotherapy with a conventional dose of rituximab -- the monoclonal antibody targeting cells with the CD20 'tag' -- in elderly patients with DLBCL.

So far, at two years out, results have been encouraging; also highlighting the importance of individual patient factors in this age group.

When a lower dose chemotherapy regimen, or R-"miniCHOP," was used, efficacy appeared to be roughly comparable at 2 years to the standard dose, but with a reduced frequency of chemotherapy-related hospitalization.


Offner F, Samoilova O, Osmanov E, et al. Frontline rituximab, cyclophosphamide, doxorubicin, and prednisone with bortezomib (VR-CAP) or vincristine (R-CHOP) for non-GCB DLBCL. Blood. 2015;126(16):1893-1901.

Eyre TA, Clifford R, Roberts C, et al. Single arm NCRI phase II study of CHOP in combination with Ofatumumab in induction and maintenance for patients with newly diagnosed Richter’s syndrome. BMC Cancer. 2015;15:52.

Bibas M, Castillo JJ. Current knowledge on HIV-associated Plasmablastic Lymphoma. Mediterr J Hematol Infect Dis. 2014;6(1):e2014064.

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