Stanford V
Encyclopedia
Stanford V is a chemotherapy regimen (with or without accompanying Radiation therapy
) intended as a first line treatment for Hodgkin's 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:
Drug Regimen
The chemotherapy part of Stanford V treatment can last anywhere from 8 to 12 weeks, depending on the staging of the disease. In many cases, this is followed by radiation therapy
for anywhere from 2 to 6 weeks to the affected areas of the body.
Stanford V is a more rigorously administered form of chemotherapy, with treatments roughly twice as fast as those of other Hodgkin's lymphoma treatments. However, in a randomized controlled study, Stanford V was inferior to ABVD. This study has been criticized for not adhering to the proper Stanford V protocol. Specifically, the radiation therapy component following chemotherapy was not properly administered in the Italian study. A retrospective study from the Memorial Sloan-Kettering Cancer Center displayed results similar to the Stanford Cancer Center's own experience. The study concluded that, "Stanford V with appropriate radiotherapy is a highly effective regimen for locally extensive and advanced HL."
Radiation therapy
Radiation therapy , radiation oncology, or radiotherapy , sometimes abbreviated to XRT or DXT, is the medical use of ionizing radiation, generally as part of cancer treatment to control malignant cells.Radiation therapy is commonly applied to the cancerous tumor because of its ability to control...
) intended as a first line treatment for Hodgkin's lymphoma
Hodgkin's lymphoma
Hodgkin's lymphoma, previously known as Hodgkin's disease, is a type of lymphoma, which is a cancer originating from white blood cells called lymphocytes...
. 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
ABVD
ABVD is a chemotherapy regimen used in the first-line treatment of Hodgkin lymphoma, supplanting the older MOPP protocol. It consists of concurrent treatment with the chemotherapy drugs:*Adriamycin *bleomycin...
. The chemical agents used are:
- A mustard derivativeNitrogen mustardThe nitrogen mustards are cytotoxic chemotherapy agents similar to mustard gas. Although their common use is medicinal, in principle these compounds can also be deployed as chemical warfare agents. Nitrogen mustards are nonspecific DNA alkylating agents. Nitrogen mustard gas was stockpiled by...
such as CyclophosphamideCyclophosphamideCyclophosphamide , also known as cytophosphane, is a nitrogen mustard alkylating agent, from the oxazophorines group....
, Mechlorethamine or IfosfamideIfosfamideIfosfamide is a nitrogen mustard alkylating agent used in the treatment of cancer.It is sometimes abbreviated "IFO".-Uses:It is given as a treatment for a variety of cancers, including:... - DoxorubicinDoxorubicinDoxorubicin INN is a drug used in cancer chemotherapy. It is an anthracycline antibiotic, closely related to the natural product daunomycin, and like all anthracyclines, it works by intercalating DNA....
, an anti-tumor antibioticAntibioticAn antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of... - VinblastineVinblastineVinblastine is an antimicrotubule drug used to treat certain kinds of cancer, including Hodgkin's lymphoma, non-small cell lung cancer, breast cancer, head and neck cancer, and testicular cancer. It is also used to treat Langerhan cell histiocytosis....
, an alkaloidAlkaloidAlkaloids are a group of naturally occurring chemical compounds that contain mostly basic nitrogen atoms. This group also includes some related compounds with neutral and even weakly acidic properties. Also some synthetic compounds of similar structure are attributed to alkaloids...
cell toxin - VincristineVincristineVincristine , formally known as leurocristine, sometimes abbreviated "VCR", is a vinca alkaloid from the Catharanthus roseus , formerly Vinca rosea and hence its name. It is a mitotic inhibitor, and is used in cancer chemotherapy.-Mechanism:Tubulin is a structural protein that polymerizes to...
, another alkaloid cell toxin - BleomycinBleomycinBleomycin is a glycopeptide antibiotic produced by the bacterium Streptomyces verticillus. Bleomycin refers to a family of structurally related compounds. When used as an anticancer agent, the chemotherapeutical forms are primarily bleomycin A2 and B2. It works by causing breaks in DNA...
, another anti-tumor antibiotic - EtoposideEtoposideEtoposide phosphate is an anti-cancer agent. It is known in the laboratory as a topoisomerase poison. Etoposide is often incorrectly referred to as a topoisomerase inhibitor in order to avoid using the term "poison" in a clinical setting...
, a DNADNADeoxyribonucleic acid is a nucleic acid that contains the genetic instructions used in the development and functioning of all known living organisms . The DNA segments that carry this genetic information are called genes, but other DNA sequences have structural purposes, or are involved in...
toxin - PrednisonePrednisonePrednisone is a synthetic corticosteroid drug that is particularly effective as an immunosuppressant drug. It is used to treat certain inflammatory diseases and some types of cancer, but has significant adverse effects...
, a corticosteroidCorticosteroidCorticosteroids are a class of steroid hormones that are produced in the adrenal cortex. Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte...
Drug Regimen
| Drug | Dose | Mode | Days |
|---|---|---|---|
| DOXORUBICIN | 25mg/m² | IV | Days 1 and 15 |
| VINBLASTINE | 6mg/m² | IV | Days 1 and 15 |
| MECHLORETHAMINE | 6mg/m² | IV | Day 1 |
| VINCRISTINE | 1.4mg/m² max 2mg) | IV | Days 8 and 22 |
| BLEOMYCIN | 5mg/m² | IV | Days 8 and 22 |
| ETOPOSIDE | 60mg/m² | IV | Days 15, 16 |
| PREDNISONE | 40mg/m² | PO | Q2D |
The chemotherapy part of Stanford V treatment can last anywhere from 8 to 12 weeks, depending on the staging of the disease. In many cases, this is followed by radiation therapy
Radiation therapy
Radiation therapy , radiation oncology, or radiotherapy , sometimes abbreviated to XRT or DXT, is the medical use of ionizing radiation, generally as part of cancer treatment to control malignant cells.Radiation therapy is commonly applied to the cancerous tumor because of its ability to control...
for anywhere from 2 to 6 weeks to the affected areas of the body.
Stanford V is a more rigorously administered form of chemotherapy, with treatments roughly twice as fast as those of other Hodgkin's lymphoma treatments. However, in a randomized controlled study, Stanford V was inferior to ABVD. This study has been criticized for not adhering to the proper Stanford V protocol. Specifically, the radiation therapy component following chemotherapy was not properly administered in the Italian study. A retrospective study from the Memorial Sloan-Kettering Cancer Center displayed results similar to the Stanford Cancer Center's own experience. The study concluded that, "Stanford V with appropriate radiotherapy is a highly effective regimen for locally extensive and advanced HL."
External links
- Lymphoma Information Network
- PMID 11821442
- Includes table for schedule