ICE (chemotherapy)
ICE in the context of chemotherapy is an acronym for one of the chemotherapy regimens, used in salvage treatment of relapsed or refractory non-Hodgkin's lymphoma and Hodgkin lymphoma.
In case of CD20-positive B cell lymphoid malignancies the ICE regimen is often combined today with rituximab. This regimen is then called ICE-R or R-ICE or RICE.
[R]-ICE regimen consists of:
- (R)ituximab - an anti-CD20 monoclonal antibody, which is able to kill both normal and malignant CD20-bearing B cells;
- (I)fosfamide - an alkylating antineoplastic agent of the oxazafosforine group;
- (C)arboplatin - a platinum-based antineoplastic drug, also an alkylating antineoplastic agent;
- (E)toposide - a topoisomerase inhibitor.
Dosing regimen
| Drug | Dose | Mode | Days |
|---|---|---|---|
| (R)ituximab | 375 mg/m2 | IV infusion | Day 1 |
| (I)fosfamide | 5000 mg/m2 | IV continuous infusion over 24 hours | Day 2 |
| Mesna for haemorrhagic cystitis prophylaxis with ifosfamide | 5000 mg/m2 | IV continuous infusion over 24 hours | Day 2 |
| (C)arboplatin | Optimized to get AUC = 5 (max. 800 mg) | IV infusion | Day 2 |
| (E)toposide | 100 mg/m2 | IV infusion over 1 hour | Days 1-3 |
| Filgrastim to shorten the period of neutropenia | 5 µg/kg | S.C. | Days 5-12 |
Cycles are repeated every 14 days for 3 cycles, then high-dose chemotherapy with autologous stem-cell transplantation follows (if the patient is considered eligible for HDCT and ASCT).[1][2]
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References
- Ifosfamide, Carboplatin, and Etoposide: A Highly Effective Cytoreduction and Peripheral-Blood Progenitor-Cell Mobilization Regimen for Transplant-Eligible Patients With Non-Hodgkin’s Lymphoma
- Rituximab and ICE as second-line therapy before autologous stem cell transplantation for relapsed or primary refractory diffuse large B-cell lymphoma
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