# VCAP-AMP-VECP compared with biweekly CHOP for adult T-cell leukemia-lymphoma: Japan Clinical Oncology Group Study JCOG9801

Source: https://onco.cc/key-papers/paper-jcog9801-vcap-amp-vecp-adult-t-cell-leukaemia-jco-2007/  
OnCo record `paper-jcog9801-vcap-amp-vecp-adult-t-cell-leukaemia-jco-2007` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The only randomised trial run exclusively in the virus-driven adult T-cell leukaemia found an intensive Japanese regimen produced more complete remissions than standard chemotherapy, at considerable cost in toxicity.

## Summary

A randomised controlled trial conducted exclusively in human T-lymphotropic virus type 1-associated adult T-cell leukaemia-lymphoma. Previously untreated patients with aggressive disease were assigned to six courses of VCAP-AMP-VECP every four weeks or eight courses of biweekly CHOP, both with granulocyte colony-stimulating factor support and intrathecal prophylaxis. 118 patients were enrolled.

The complete response rate was 40 per cent with VCAP-AMP-VECP against 25 per cent with biweekly CHOP (p = 0.020). One-year progression-free survival was 28 against 16 per cent (p = 0.100, two-sided p = 0.200) and three-year overall survival 24 against 13 per cent (p = 0.085, two-sided p = 0.169). Grade 4 neutropenia occurred in 98 against 83 per cent, grade 4 thrombocytopenia in 74 against 17 per cent and grade 3 or 4 infection in 32 against 15 per cent, with three toxic deaths in the VCAP-AMP-VECP arm.

## Fields

- Kind: Key paper
- Last checked: 2026-10-01
- Also known as: JCOG9801; Tsukasaki 2007; LSG15
- Tags: lymphoma-evidence
- Journal: Journal of Clinical Oncology
- Year: 2007
- DOI: 10.1200/JCO.2007.11.9958
- Authors: Tsukasaki K, Utsunomiya A, Fukuda H, et al.
- Findings: The complete response rate was 40 per cent with VCAP-AMP-VECP against 25 per cent with biweekly CHOP (p = 0.020).; One-year progression-free survival was 28 per cent against 16 per cent (p = 0.100, two-sided p = 0.200).; Three-year overall survival was 24 per cent against 13 per cent (p = 0.085, two-sided p = 0.169).; Grade 4 thrombocytopenia occurred in 74 per cent against 17 per cent, and grade 3 or 4 infection in 32 against 15 per cent.; Three toxic deaths occurred in the VCAP-AMP-VECP arm.
- What it means: The Japanese standard regimen for aggressive adult T-cell leukaemia/lymphoma rests on this trial. Three-year overall survival of 24 per cent with the better arm is the plainest statement of how much room remains, and is why allogeneic transplantation, mogamulizumab and antiviral approaches have all been pursued since.
- Caveats: The survival and progression-free survival differences did not reach statistical significance on two-sided testing; the significant endpoint was complete response rate.; 118 patients is small, and the trial has never been repeated.; Conducted entirely in Japan, where the virus is endemic and supportive care is intensive; the regimen has not been adopted widely elsewhere.; OnCo has no cancer record for adult T-cell leukaemia/lymphoma yet, so this record is attached to peripheral T-cell lymphoma.

## Sources

- Journal of Clinical Oncology 2007: https://doi.org/10.1200/JCO.2007.11.9958
- PubMed: https://pubmed.ncbi.nlm.nih.gov/17968021/
- Europe PMC: https://europepmc.org/article/MED/17968021

## Connected records

- key papers: [Adult T-cell leukemia: antigen in an ATL cell line and detection of antibodies to the antigen in human sera](https://onco.cc/key-papers/paper-hinuma-adult-t-cell-leukaemia-antigen-pnas-1981/), [Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma](https://onco.cc/key-papers/paper-poiesz-htlv-retrovirus-cutaneous-t-cell-lymphoma-pnas-1980/)
- 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/)
- cancers: [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/)
- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Cyclophosphamide](https://onco.cc/drugs/cyclophosphamide/), [Doxorubicin](https://onco.cc/drugs/doxorubicin/), [Etoposide](https://onco.cc/drugs/etoposide/), [Prednisone](https://onco.cc/drugs/prednisone/), [Vincristine](https://onco.cc/drugs/vincristine/)
- terms: [Complete response](https://onco.cc/terms/complete-response/), [Intrathecal therapy (lumbar puncture, Ommaya reservoir)](https://onco.cc/terms/intrathecal-therapy/)
- trials: [JCOG9801](https://onco.cc/trials/jcog9801/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Rare and paediatric cancers without markets](https://onco.cc/bottlenecks/b-rare-cancers/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)
- 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/)

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