FCM (chemotherapy)

FCM, or FMC in the context of chemotherapy is an acronym for a chemotherapy regimen that is often used in the treatment of indolent B cell non-Hodgkin's lymphomas.

In combination with Rituximab this regimen is called R-FCM or R-FMC, or FCM-R, FMC-R.

The [R]-FCM regimen contains

1. (R)ituximab - anti-CD20 monoclonal antibody that can kill both normal and malignant CD20-bearing B cells;
2. (F)ludarabine - an antimetabolite;
3. (C)yclophosphamide - an alkylating antineoplastic agent from the oxazafosforine group;
4. (M)itoxantrone - a synthetic antracycline analogue (antraquinone) that can intercalate DNA, thereby preventing cell division.^[1]

The FCM or R-FCM regimen is also sometimes used in some autoimmune diseases that are inherently sensitive to the use of rituximab, fludarabine, mitoxantrone, and cyclophosphamide alone in monotherapies (e.g., in severe multiple sclerosis flares).

Dosing regimen

Drug	Dose	Mode	Days
(R)ituximab	375 mg/m^2	IV infusion	Day 0
(F)ludarabine	25 mg/m^2	IV infusion over 30 min	Days 1-3
(C)yclophosphamide	200 mg/m^2	IV infusion over 4 hours	Days 1-3
(M)itoxantrone	8 mg/m^2	IV infusion over 30 min	Day 1

References

1. http://www.bloodjournal.org/content/104/10/3064.full?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=104&firstpage=3064&resourcetype=HWCIT&sso-checked=true The addition of rituximab to a combination of fludarabine, cyclophosphamide, mitoxantrone (FCM) significantly increases the response rate and prolongs survival as compared with FCM alone in patients with relapsed and refractory follicular and mantle cell lymphomas: results of a prospective randomized study of the German Low-Grade Lymphoma Study Group]