# ECHELON-2

Source: https://onco.cc/trials/echelon-2/  
OnCo record `echelon-2` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

ECHELON-2 was the first trial in decades to improve on CHOP chemotherapy for T-cell lymphoma: swapping vincristine for the antibody-drug conjugate brentuximab vedotin helped patients live longer, especially those with anaplastic large cell lymphoma.

## Summary

ECHELON-2 randomised 452 patients with previously untreated CD30-positive peripheral T-cell lymphoma, about 70 percent of them with systemic anaplastic large cell lymphoma, to six to eight cycles of brentuximab vedotin plus cyclophosphamide, doxorubicin and prednisone (A+CHP) or to standard CHOP. The primary endpoint was progression-free survival by independent review.

A+CHP lengthened progression-free survival and, unusually for a lymphoma trial, overall survival, with a similar rate of peripheral neuropathy to CHOP. It was approved in the United States in November 2018 for CD30-expressing peripheral T-cell lymphomas and is the standard front-line regimen for anaplastic large cell lymphoma; its benefit in the other CD30-positive histologies is less certain because they were a minority of the trial.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-17
- Tags: subtype-trials
- Registry id: NCT01777152
- Phase: 3
- Setting: Untreated CD30-positive peripheral T-cell lymphoma: brentuximab vedotin with cyclophosphamide, doxorubicin and prednisone (A+CHP) against CHOP
- Sponsor: Seagen (Pfizer) with Takeda
- Enrolled: 452
- Result: A+CHP improved progression-free and overall survival over CHOP in CD30-positive peripheral T-cell lymphoma; approved in November 2018.
- Outcomes: Progression-free survival (blinded independent central review): A+CHP (brentuximab vedotin, cyclophosphamide, doxorubicin, prednisone) 48.2 months vs CHOP 20.8 months, HR 0.71; Febrile neutropenia: A+CHP (brentuximab vedotin, cyclophosphamide, doxorubicin, prednisone) 18% vs CHOP 15%; Peripheral neuropathy: A+CHP (brentuximab vedotin, cyclophosphamide, doxorubicin, prednisone) 52% vs CHOP 55%

## Sources

- ClinicalTrials.gov NCT01777152: https://clinicaltrials.gov/study/NCT01777152

## Connected records

- roadmaps: [Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting](https://onco.cc/roadmaps/lymphoma-roadmap/)
- trials: [JCOG9801](https://onco.cc/trials/jcog9801/), [SMILE](https://onco.cc/trials/smile-enktl/)
- ideas: [Randomised evidence for the T-cell lymphomas, including the ones that are not in Europe or North America](https://onco.cc/ideas/lymphoma-ev-randomised-evidence-for-the-t-cell-lymphomas/)
- cancers: [ALK-negative anaplastic large cell lymphoma](https://onco.cc/cancers/alk-negative-anaplastic-large-cell-lymphoma/), [ALK-positive anaplastic large cell lymphoma](https://onco.cc/cancers/alk-positive-anaplastic-large-cell-lymphoma/), [Non-Hodgkin lymphoma (all types)](https://onco.cc/cancers/non-hodgkin-lymphoma/), [Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)](https://onco.cc/cancers/peripheral-t-cell-lymphoma/)
- technologies: [Antibody-drug conjugate (ADC)](https://onco.cc/technologies/adc/)
- drugs: [Brentuximab vedotin](https://onco.cc/drugs/brentuximab-vedotin/), [Cyclophosphamide](https://onco.cc/drugs/cyclophosphamide/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Prednisone](https://onco.cc/drugs/prednisone/), [Vincristine](https://onco.cc/drugs/vincristine/)
- companies: [Pfizer (incl. Seagen)](https://onco.cc/companies/pfizer/), [Takeda](https://onco.cc/companies/takeda/)
- people: [Steven M. Horwitz](https://onco.cc/people/steven-horwitz/)

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