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:

  1. Rituximab - an anti-CD20 monoclonal antibody, which is able to kill both normal and malignant CD20-bearing B cells;
  2. Ifosfamide - an alkylating antineoplastic agent of the oxazafosforine group;
  3. Carboplatin - a platinum-based antineoplastic drug, also an alkylating antineoplastic agent;
  4. Etoposide - a topoisomerase inhibitor.

Dosing regimen

DrugDoseModeDays
Rituximab375 mg/m2IV infusionDay 1
Ifosfamide5000 mg/m2IV continuous infusion over 24 hoursDay 2
Mesna for haemorrhagic cystitis prophylaxis with ifosfamide5000 mg/m2IV continuous infusion over 24 hoursDay 2
CarboplatinOptimized to get AUC = 5 (max. 800 mg)IV infusionDay 2
Etoposide100 mg/m2IV infusion over 1 hourDays 1-3
Filgrastim to shorten the period of neutropenia5 µg/kgS.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]

References

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