Anti-cancer drugs are an important component of treatment for many forms of non-Hodgkin lymphoma (NHL). Treatment with these drugs (known as chemotherapy) often involves combining two or more drugs, given in cycles. The drugs are administered through a needle placed in a vein. This ordinarily takes an hour or more. Depending on a patient’s particular type and stage of lymphoma, doctors may prescribe, for example, five days of chemotherapy, followed by a rest and recovery period, followed by another round of daily chemo for another week, and so on. Three to eight cycles of chemo/rest are not unusual for the treatment of lymphoma.
Such a treatment regimen, using repeating cycles of multiple drugs, maximizes overall effectiveness by attacking cancer cells in a number of different ways. Some drugs, when added together, work better than any single drug would work on its own. This effect, called synergism, can improve the likelihood that the maximum number of cancerous cells will be destroyed. Using several drugs in lower doses also helps reduce potential side effects, without sacrificing overall effectiveness.
As an example of combination drug regimens, diffuse large B-cell lymphoma is often treated with cyclophosphamide, doxorubicin or hydroxydaunorubicin, vincristine and prednisone. This combination is referred to as CHOP; an acronym derived from the chemical names of the component drugs. Combining several chemotherapeutic drugs also reduces the chances that tumor cells will develop resistance to a given drug’s effectiveness.
Dozens of drugs are used in chemotherapy for NHL. They are classified according to the specific ways in which they kill cancer cells. Classes, and representative drugs, include:
- DNA-altering drugs (e.g. Cisplatin, Bendamustine and Cyclophosphamide)
- anti-tumor antibiotics (e.g. Bleomycin and Doxorubicin)
- antimetabolites (e.g. Gemcitabine, Pentostatin and Methotrexate)
- hormones (e.g. Dexamethasone and Prednisone)
- drugs that block cell division (e.g. Vincristine and Vinblastine)