Loading
MATRix/IELSG43 settled how to consolidate remission in lymphoma of the brain: after MATRix chemotherapy, a high-dose chemotherapy and stem cell transplant kept 78 percent of patients free of progression at three years against 51 percent with conventional consolidation chemotherapy, and also lengthened survival, so transplant is now the preferred consolidation for fit patients.
MATRix/IELSG43 was a randomised phase 3 trial of the German and IELSG groups in 368 patients aged 18 to 70 with newly diagnosed primary CNS lymphoma. All received four cycles of MATRix (methotrexate, cytarabine, thiotepa, rituximab); 230 patients with responding or stable disease were randomised to high-dose chemotherapy (carmustine and thiotepa) with autologous stem cell transplant or to two cycles of non-myeloablative R-DeVIC. The primary endpoint was progression-free survival.
At a median follow-up of 45.3 months three-year progression-free survival was 78 percent after transplant against 51 percent after R-DeVIC (hazard ratio 0.43), and overall survival was also better. Adverse events were more frequent with transplant (14.6 against 9.3 per patient) and five patients died after transplant consolidation against two after R-DeVIC. The corpus's primary CNS lymphoma page cites IELSG43 with IELSG32 for thiotepa-based chemotherapy with autologous transplant.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
368 registered.
95% CI 69 to 85; median follow-up 45.3 months · 95% CI 41 to 60
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival at 3 yearsprimary | High-dose carmustine-thiotepa and autologous stem cell transplant | 114 | 78% | 0.43 (0.27 to 0.68) | 0.0003 | link |
| R-DeVIC non-myeloablative consolidation | 115 | 51% | ||||
| Mean adverse events per patient | High-dose carmustine-thiotepa and autologous stem cell transplant | 114 | 14.6 | - | - | link |
| R-DeVIC non-myeloablative consolidation | 115 | 9.3 | ||||
| Fatal serious adverse events after consolidation | High-dose carmustine-thiotepa and autologous stem cell transplant | 114 | 5 participants | - | - | link |
| R-DeVIC non-myeloablative consolidation | 115 | 2 participants |
Shares Thiotepa, Ifosfamide, Autologous stem cell transplant (high-dose therapy), Brain and spinal cord tumours (all types) and the tag soc-trials.
Shares Thiotepa, Autologous stem cell transplant (high-dose therapy), Brain and spinal cord tumours (all types), Methotrexate and the tag soc-trials.
Shares Carmustine, Cytarabine, Autologous stem cell transplant (high-dose therapy), Etoposide and the tag soc-trials.
Shares Ifosfamide, Brain and spinal cord tumours (all types), Etoposide, Carboplatin and the tag soc-trials.
Shares Cytarabine, Autologous stem cell transplant (high-dose therapy), Rituximab, 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 and the tag soc-trials.
Shares Brain and spinal cord tumours (all types), Etoposide, Carboplatin, Cytotoxic chemotherapy and the tag soc-trials.
Shares Rituximab, 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, Non-Hodgkin lymphoma (all types), Cytotoxic chemotherapy and the tag soc-trials.
Shares Ifosfamide, Etoposide, Cytotoxic chemotherapy and the tag soc-trials.