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Adding rituximab and thiotepa to methotrexate and cytarabine doubled the complete remission rate for lymphoma confined to the brain, making the four-drug MATRix regimen the standard induction for patients up to 70.
First randomisation of the international phase 2 IELSG32 trial: 227 patients aged 18 to 70 with newly diagnosed primary CNS lymphoma were randomised to four courses of methotrexate and cytarabine alone, with rituximab, or with rituximab and thiotepa (MATRix).
At a median follow-up of 30 months the complete remission rate was 49 percent with MATRix against 23 percent with methotrexate-cytarabine alone (hazard ratio 0.46) and 30 percent with rituximab added (hazard ratio 0.61). Grade 4 haematological toxicity was more frequent with MATRix but infections were similar; 13 patients (6 percent) died of toxicity.
MATRix became the reference induction for fit patients with primary CNS lymphoma and the control arm of later randomised trials.
Shares The Lancet Haematology, IELSG32, Thiotepa, Primary CNS lymphoma.
Shares IELSG32, Thiotepa, Cytarabine, Primary CNS lymphoma.
Shares IELSG32, Cytarabine, Primary CNS lymphoma, Methotrexate.
Shares Cytarabine, Methotrexate, Rituximab.
Shares Thiotepa, Primary CNS lymphoma.
Shares Primary CNS lymphoma, Methotrexate, Rituximab.
Shares Primary CNS lymphoma, Methotrexate, Rituximab.
Shares Cytarabine, Methotrexate, Rituximab.