{"entity":{"id":"echelon-2","kind":"trial","name":"ECHELON-2","aka":[],"tldr":"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.\n\nA+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.","status":"positive","asOf":"2026-09-17","links":[{"label":"ClinicalTrials.gov NCT01777152","url":"https://clinicaltrials.gov/study/NCT01777152"}],"tags":["subtype-trials"],"related":["lymphoma-roadmap","jcog9801","smile-enktl","lymphoma-ev-randomised-evidence-for-the-t-cell-lymphomas"],"cancers":["peripheral-t-cell-lymphoma","non-hodgkin-lymphoma"],"sections":[],"technologies":["adc"],"targets":[],"drugs":["brentuximab-vedotin","cyclophosphamide","doxorubicin","prednisone","vincristine"],"companies":["pfizer","takeda"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["steven-horwitz"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"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","result":"A+CHP improved progression-free and overall survival over CHOP in CD30-positive peripheral T-cell lymphoma; approved in November 2018.","started":"2013-01-31","startedType":"actual","yearReported":2018,"enrolled":452,"enrolledBasis":"registry","outcomes":[{"endpoint":"Progression-free survival (blinded independent central review)","primary":true,"unit":"months","arms":[{"name":"A+CHP (brentuximab vedotin, cyclophosphamide, doxorubicin, prednisone)","n":226,"value":48.2},{"name":"CHOP","n":226,"value":20.8}],"hr":0.71,"ci":[0.54,0.93],"p":"0.0110","source":"https://doi.org/10.1016/s0140-6736(18)32984-2"},{"endpoint":"Febrile neutropenia","unit":"%","arms":[{"name":"A+CHP (brentuximab vedotin, cyclophosphamide, doxorubicin, prednisone)","n":226,"value":18},{"name":"CHOP","n":226,"value":15}],"source":"https://doi.org/10.1016/s0140-6736(18)32984-2"},{"endpoint":"Peripheral neuropathy","unit":"%","arms":[{"name":"A+CHP (brentuximab vedotin, cyclophosphamide, doxorubicin, prednisone)","n":226,"value":52},{"name":"CHOP","n":226,"value":55}],"source":"https://doi.org/10.1016/s0140-6736(18)32984-2"}]},"route":"/trials/echelon-2/","neighbours":{"roadmap":[{"id":"lymphoma-roadmap","kind":"roadmap","name":"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","route":"/roadmaps/lymphoma-roadmap/"}],"trial":[{"id":"jcog9801","kind":"trial","name":"JCOG9801","route":"/trials/jcog9801/"},{"id":"smile-enktl","kind":"trial","name":"SMILE","route":"/trials/smile-enktl/"}],"idea":[{"id":"lymphoma-ev-randomised-evidence-for-the-t-cell-lymphomas","kind":"idea","name":"Randomised evidence for the T-cell lymphomas, including the ones that are not in Europe or North America","route":"/ideas/lymphoma-ev-randomised-evidence-for-the-t-cell-lymphomas/"}],"cancer":[{"id":"alk-negative-anaplastic-large-cell-lymphoma","kind":"cancer","name":"ALK-negative anaplastic large cell lymphoma","route":"/cancers/alk-negative-anaplastic-large-cell-lymphoma/"},{"id":"alk-positive-anaplastic-large-cell-lymphoma","kind":"cancer","name":"ALK-positive anaplastic large cell lymphoma","route":"/cancers/alk-positive-anaplastic-large-cell-lymphoma/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"peripheral-t-cell-lymphoma","kind":"cancer","name":"Peripheral T-cell lymphomas (including cutaneous T-cell lymphoma)","route":"/cancers/peripheral-t-cell-lymphoma/"}],"technology":[{"id":"adc","kind":"technology","name":"Antibody-drug conjugate (ADC)","route":"/technologies/adc/"}],"drug":[{"id":"brentuximab-vedotin","kind":"drug","name":"Brentuximab vedotin","route":"/drugs/brentuximab-vedotin/"},{"id":"cyclophosphamide","kind":"drug","name":"Cyclophosphamide","route":"/drugs/cyclophosphamide/"},{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"prednisone","kind":"drug","name":"Prednisone","route":"/drugs/prednisone/"},{"id":"vincristine","kind":"drug","name":"Vincristine","route":"/drugs/vincristine/"}],"company":[{"id":"pfizer","kind":"company","name":"Pfizer (incl. Seagen)","route":"/companies/pfizer/"},{"id":"takeda","kind":"company","name":"Takeda","route":"/companies/takeda/"}],"person":[{"id":"steven-horwitz","kind":"person","name":"Steven M. Horwitz","route":"/people/steven-horwitz/"}]}}