Lymphoma clinical trials

Lymphoma clinical trials

We are supporting trials in lymphoma that will deliver improvements to people living with this blood cancer.

A trial in Burkitt's lymphoma is comparing the standard chemotherapy with a new chemotherapy schedule, which could have less side effects, and it can be given in an outpatient setting with hospital visits rather than an hospital stay.

Our diffuse large B-cell lymphoma trials are looking for new ways to treat people who have not responded to the standard treatment of chemotherapy and antibody therapy.

Two peripheral T-cell lymphoma (PTCL) trials are testing new treatments for peopl who have not responded to chemotherapy, or who have relapsed after treatment.

 

We also have a Hodgkin lymphoma trial that wants to individually tailor treatment for each child, effectively treating the disease, but avoiding over-treatment and thereby reducing the late side-effects. And we have a trial which is looking a targeted biological therapy called brentuximab vedotin in adults with Hodgkin lymphoma who are unable to have standard chemotherapy.

And we have trials that want to improve the outcome for people with rarer lymphomas, such as peripheral central nervous system (PCNS) lymphoma, and post-transplant lymphoproliferative disorders (PTLD).

Burkitt lymphoma

Updated 06 Jun 2018

Burkitt Lymphoma is an extremely aggressive form of non-Hodgkin lymphoma. Although treatment with chemotherapy is now very successful, it involves prolonged care within the hospital and treatment can cause severe side effects.

We are supporting a clinical trial that wants to compared the standard chemotherapy treatment - R-CODOX-M or R-IVAC - with a new chemotherapy schedule called DA EPOCH–R. Researchers think that DA EPOCH-R may have less side effects, and it can be given in an outpatient setting with hospital visits.

 

HOVON 127 BL trial

Chief investigator - Dr Andrew McMillan, University College London
High-grade non-Hodgkin lymphoma (HGNHL) Burkitt lymphoma
Phase III study comparing R-CODOX-M/R-IVAC versus dose-adjusted EPOCH-R (DA-EPOCH-R) for patients with newly diagnosed high risk Burkitt lymphoma Blood cancer type: Lymphoma/Burkitt lymphoma
Researchers want to find new ways to treat Burkitts lymphoma, and are comparing standard chemotherapy (R-CODOX-M or R-IVAC) with a different schedule (DA EPOCH-R) that appears to work well and has less side effects.

Childhood Hodgkin lymphoma (Ch-HL)

Survivorship for children and young adults with Hodgkin lymphoma has improved greatly in recent years, and it can now mainly be treated successfully with chemotherapy and radiotherapy.

But cure often comes at the expense of long-term health problems due to side effects of treatment, particularly radiotherapy, which may cause secondary cancers, cardiac problems and other serious complications.

We are supporting a trial that wants to individually tailor treatment for each child and young adult, effectively treating Hodgkin lymphoma, but avoiding over-treatment and thereby reducing the late side-effects.

 

EuroNet-PHL-C2 trial

Chief investigator - Dr Stephen Daw, University College Hospital, London
Lymphoma
European Network of paediatric Hodgkin lymphoma second international inter-group study for classical Hodgkin lymphoma in children and adolescents
Treatment for Hodgkin lymphoma is often very successful, and has given us high cure rates. Standard treatment is chemotherapy, and in children and young people, additional radiotherapy is sometimes needed. But unfortunately, radiotherapy can lead to long-term side effects. In this trial, researchers want to individually tailor treatment for each child and young person, effectively treating Hodgkin lymphoma, but avoiding over-treatment and thereby reducing the late side-effects.

Diffuse large B cell lymphoma (DLBCL)

Diffuse large B-cell lymphoma (DLBCL) is usually treated by chemotherapy together with an antibody therapy called rituximab. However, this approach is not always successful - many people do not respond, or only have a partial response, so further 'salvage' treatment is needed. If salvage treatment is unsucessful, a stem cell transplant may be given, but sometimes the DLBCL returns after this. 

We are looking for new ways to treat people with DLBCL who have not responded to the standard treatment of chemotherapy and antibody therapy.

The TORCH trial is looking at a new drug called vistusertib for people with DLBCL that has continued to grow during standard treatment, or has come back afterwards.

We are also supporting the COBALT trial, which is using a CAR-T therapy in people who have DLBCL that has returned after a stem cell transplant. CAR-T therapy involves researchers genetically modifiying donor immune cells (T-cells) to seek out the DLBCL cancer cells in patients, and it's the first time this type of treatment has been used for people with DLBCL.

 

 

COBALT trial

Chief investigator - Dr Karl Peggs, University College London
High-grade non-Hodgkin lymphoma (HGNHL)
Evaluating CAR19 as an optimal bridge to allogeneic transplantation
For the first time in the UK, Professor Peggs is running a trial that will use CAR-T therapy to reduce the amount of DLBCL cells present, so people can be well enough to undergo a stem cell transplant. He will be using a CAR-T therapy, which works by modifying a patient's T-cells to recognise a protein called CD19 found on the surface of lymphoma cells. 

TORCH trial

Chief investigator - Dr Graham Collins, Oxford University Hospitals NHS Trust
Lymphoma Diffuse large B cell lymphoma (DLBCL)
A phase II study to determine the safety and efficacy of the dual mTORC inhibitor AZD2014 and to investigate additional toxicities in combination with rituximab in relapsed refractory DLBCL
This trial is looking at a new biological therapy called vistusertib for people with diffuse B cell lymphoma (DLBCL) that has continued to grow during standard treatment of chemotherapy and rituximab, or has come back afterwards. 

Hodgkin lymphoma

People with Hodgkin lymphoma are usually treated with chemotherapy, but some are too frail to have this type of treatment, or have another medical condition which means they cannot have chemotherapy.

We are supporting the BREVITY trial, which is looking a targeted biological therapy called brentuximab vedotin.

Brentuximab vedotin has been shown to be effective for people whose Hodgkin lymphoma has come back after chemotherapy treatment, and researchers want to see if this drug may also help people who can’t have standard chemotherapy. 

Peripheral T-cell lymphoma (PTCL)

Peripheral T-cell lymphoma (PTCL) is fast-growing, and needs to be treated quickly. People with PTCL are usually given a combination of chemotherapy drugs, but this may not work for everyone. And for people who relapse after this course of treatment, there are limited treatment options available.

We are supporting two clinical trials looking into new treatments for this group of people.

The AVAIL-T trial is looking at an antibody drug called avelumab, which has been used to treat other cancer types with some success. We are also supporting a trial called RomiCAR which wants to know if combining two targeted drugs - romidepsin and carfilzomib - could help people with PTCL that has come back, or standard treatment has stopped working for them.

RomiCar trial

Chief investigator - Dr Graham Collins, Oxford University Hospitals NHS Trust
Lymphoma Burkitt lymphoma
A phase I/II study to determine the maximum tolerated dose and overall response rate of the combination of romidepsin and carfilzomib in relapsed or refractory peripheral T-cell lymphoma
People with peripheral T-cell lymphoma (PTCL) are usually given chemotherapy, but sometimes it continues to grow, or comes back after the treatment has finished. Researchers want to know if combining romidepsin - a HDAC inhibitor - and carfilzomib - a proteasome inhibitor - could help people with PTCL that has come back, or standard treatment has stopped working for them.

Post-transplant lymphoproliferative disorder (PTLD)

Post-transplant lymphoproliferative disorders (PTLD) are a diverse group of high grade lymphomas, and are one of the most severe complications of long-term immunosuppression that happens in people who have undergone solid organ transplantation.

Currently, people are treated with a biological therapy called rituximab, but they can also be given chemotherapy if they do not respond adequately. Although this strategy is often successful, many people do not respond or relapse. 

We are supporting a trial that wants to know if giving a biological drug called ibrutinib improves the response rate in people with PTLD when added to chemotherapy.

Primary central nervous system lymphoma (PCNSL)

Peripheral central nervous system (PCNS) lymphoma is rare. These types of lymphomas start in the brain or spinal cord (central nervous system).

People with PCNS lymphoma are usually given chemotherapy with the biologic drug rituximab. This course of treatment often works well, but the outlook for the large proportion of people with PCNS lymphoma who relapse is poor. 

Our researchers are looking for new treatments for people with PCNS in a clinical trial called TIER. 

TIER trial

Chief investigator - Dr Christopher Fox, Nottingham University Hospitals NHS Trust
Lymphoma
A phase I/II study of thiotepa, ifosphamide, etoposide and rituximab for the treatment of relapsed and refractory primary central nervous system lymphoma
Researchers are looking for new ways to treat people with PCNSL - a rare type of non-Hodgkin lymphoma that only affects the central nervous system. The trial is trying a new combination of cancer drugs comprising of chemotherapies and a biologic drug.