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MOPP is a combination chemotherapy regimen used to treat Hodgkin lymphoma. The acronym is derived from the component drugs of the regimen:
The treatment is usually administered in four week cycles, often for six cycles. MSD and VCR are administered intravenously, while procarbazine and prednisone are pills taken orally. A newer Hodgkin lymphoma treatment is ABVD.
C-MOPP involves switching the nitrogen mustard from mechlorethamine to cyclophosphamide. C-MOPP is thus very similar to COPP, using the same 4 agents and differing at most in dosages and timing.
Drug | Dose | Mode | Days |
---|---|---|---|
(M)ustargen | 6 mg/m2 | IV bolus | Days 1 and 8 |
(O)ncovin | 1.4 mg/m2 (max. 2 mg) | IV bolus | Days 1 and 8 |
(P)rocarbazine | 100 mg/m2 | PO qd | Days 1-14 |
(P)rednisone | 40 mg/m2 | PO qd | Days 1-14 |
MOPP was the first combination chemotherapy brought in that achieved a high success rate. It was developed at the National Cancer Institute in the 1960s by a team that included Vincent DeVita, Jr.
Although no longer the most effective combination, MOPP is still used after relapse or where the patient has certain allergies or lung or heart problems which prevents the use of another regimen.
There is 20% chance of developing a second cancer within 20 years of MOPP treatment. As a result, MOPP is rarely used any more for treatment for Hodgkin lymphoma. [1] MOPP has been known to cause alopecia (hair loss) and skin sensitivity (especially to sunlight). Nausea, vomiting, and stomach ache are common, as are chills, constipation, and frequent urination. Permanent sterility is a frequent side effect. [2]
Lymphoma is a group of blood and lymph tumors that develop from lymphocytes. The name usually refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enlarged lymph nodes, fever, drenching sweats, unintended weight loss, itching, and constantly feeling tired. The enlarged lymph nodes are usually painless. The sweats are most common at night.
Cyclophosphamide (CP), also known as cytophosphane among other names, is a medication used as chemotherapy and to suppress the immune system. As chemotherapy it is used to treat lymphoma, multiple myeloma, leukemia, ovarian cancer, breast cancer, small cell lung cancer, neuroblastoma, and sarcoma. As an immune suppressor it is used in nephrotic syndrome, granulomatosis with polyangiitis, and following organ transplant, among other conditions. It is taken by mouth or injection into a vein.
Chlormethine, also known as mechlorethamine, mustine, HN2, and embikhin (эмбихин), is a nitrogen mustard sold under the brand name Mustargen among others. It is the prototype of alkylating agents, a group of anticancer chemotherapeutic drugs. It works by binding to DNA, crosslinking two strands and preventing cell duplication. It binds to the N7 nitrogen on the DNA base guanine. As the chemical is a blister agent, its use is strongly restricted within the Chemical Weapons Convention where it is classified as a Schedule 1 substance.
The era of cancer chemotherapy began in the 1940s with the first use of nitrogen mustards and folic acid antagonist drugs. The targeted therapy revolution has arrived, but many of the principles and limitations of chemotherapy discovered by the early researchers still apply.
Procarbazine is a chemotherapy medication used for the treatment of Hodgkin's lymphoma and brain cancers. For Hodgkin's it is often used together with chlormethine, vincristine, and prednisone while for brain cancers such as glioblastoma multiforme it is used with lomustine and vincristine. It is typically taken by mouth.
Dacarbazine (DTIC), also known as imidazole carboxamide, is a chemotherapy medication used in the treatment of melanoma and Hodgkin's lymphoma. For Hodgkin's it is often used together with vinblastine, bleomycin, and doxorubicin. It is given by injection into a vein.
CHOP is the acronym for a chemotherapy regimen used in the treatment of non-Hodgkin lymphoma. CHOP consists of:
Chlorambucil, sold under the brand name Leukeran among others, is a chemotherapy medication used to treat chronic lymphocytic leukemia (CLL), Hodgkin lymphoma, and non-Hodgkin lymphoma. For CLL it is a preferred treatment. It is given by mouth.
A chemotherapy regimen is a regimen for chemotherapy, defining the drugs to be used, their dosage, the frequency and duration of treatments, and other considerations. In modern oncology, many regimens combine several chemotherapy drugs in combination chemotherapy. The majority of drugs used in cancer chemotherapy are cytostatic, many via cytotoxicity.
Stanford V, is a chemotherapy regimen intended as a first-line treatment for Hodgkin lymphoma. The regimen was developed in 1988, with the objective of maintaining a high remission rate while reducing the incidence of acute and long term toxicity, pulmonary damage, and sterility observed in alternative treatment regimens such as ABVD. The chemical agents used are:
ABVD is a chemotherapy regimen used in the first-line treatment of Hodgkin lymphoma, replacing the older MOPP protocol. It consists of concurrent treatment with the chemotherapy drugs:
BEACOPP is a chemotherapy regimen for treatment of Hodgkin lymphoma developed by the German Hodgkin Study Group used for patients in Stages > II or early with unfavorable risk factors. Patients typically receive treatment in cycles of 21 days with no drugs given on days 15–21. There also exists a more intensive regimen with cycles of 14 days. Usually a course of BEACOPP therapy consists of four, sometimes six to eight cycles, or in combination with ABVD. In some countries BEACOPP still is experimental, in others it is a standard therapy. In the United States, ABVD is generally given instead, because BEACOPP is perceived by practicing oncologists to have the potential to induce more secondary neoplasias. However, the final results from the GHSG HD14 trial indicate that "there were no overall differences in treatment-related mortality or secondary malignancies" of BEACOPP relative to ABVD.
COPP is a chemotherapy regimen for treatment of Hodgkin disease, consisting of concurrent treatment with (C)yclophosphamide, (O)ncovin, (P)rocarbazine and (P)rednisone.
An alkylating antineoplastic agent is an alkylating agent used in cancer treatment that attaches an alkyl group (CnH2n+1) to DNA.
Bendamustine, sold under the brand name Treanda among others, is a chemotherapy medication used in the treatment of chronic lymphocytic leukemia (CLL), multiple myeloma, and non-Hodgkin's lymphoma. It is given by injection into a vein.
Emil J. Freireich was an American hematologist, oncologist, and cancer biologist. He was recognized as a pioneer in the treatment of cancer and use of chemotherapy and is often known as the father of modern leukemia therapy.
George P. Canellos is an American oncologist and cancer researcher. His research career spans many decades, as well as several areas of therapeutic agents for the treatment of malignant diseases. He is perhaps most known for his work with Vincent T. DeVita in which he developed the combination chemotherapy CMF, which was one of the first combination therapies for breast cancer. The two also collaborated to create the MOPP regimen for Hodgkin's lymphoma.
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a slow-growing CD20 positive form of Hodgkin lymphoma, a cancer of the immune system's B cells.
Brentuximab vedotin, sold under the brand name Adcetris, is an antibody-drug conjugate medication used to treat relapsed or refractory Hodgkin lymphoma (HL) and systemic anaplastic large cell lymphoma (ALCL), a type of T cell non-Hodgkin lymphoma. It selectively targets tumor cells expressing the CD30 antigen, a defining marker of Hodgkin lymphoma and ALCL. The drug is being jointly marketed by Millennium Pharmaceuticals outside the US and by Seattle Genetics in the US.
VAMP regimen or VAMP chemotherapy is a four-drug combination chemotherapy regimen, used today in the treatment of Hodgkin lymphoma. It was one of the earliest combination chemotherapy regimens, originally developed as a treatment for childhood leukemia by a group of researchers at the National Cancer Institute led by Emil Frei and Emil Freireich. The first clinical trial of VAMP began in 1961. Because it was the first time that four chemotherapeutic agents were used at once, the trial was highly controversial at its time. Although new combination chemotherapy regimens have replaced the use of VAMP in the treatment of childhood leukemia, VAMP is considered an important precursor to modern treatments, confirming the effectiveness of combination chemotherapy and leading to the use of combination chemotherapy regimens to treat other types of cancer.