{"entity":{"id":"arched","kind":"trial","name":"ARCHED","aka":["ARCHED trial","Acalabrutinib with R-miniCHOP"],"tldr":"A German trial adding a targeted tablet to the reduced-dose chemotherapy used for older people with aggressive lymphoma, to see whether it delays relapse.","summary":"Bruton tyrosine kinase inhibitors have a clear rationale in the activated B-cell genetic subtypes of diffuse large B-cell lymphoma, which depend on chronic active B-cell receptor signalling, and a mixed record in practice: the PHOENIX trial of ibrutinib with R-CHOP improved outcomes in patients under 60 and harmed those over 60, because of toxicity rather than biology. Acalabrutinib is more selective and better tolerated.\n\nARCHED randomises older adults with untreated diffuse large B-cell lymphoma between R-miniCHOP alone and R-miniCHOP with acalabrutinib. The primary endpoint is investigator-assessed progression-free survival, with primary completion estimated for February 2029, and the trial is running at German sites.\n\nIt is the direct test of whether the age signal in PHOENIX was a property of ibrutinib or of the class, in the population where the answer matters most.","status":"active","asOf":"2026-10-01","links":[{"label":"ClinicalTrials.gov NCT05820841","url":"https://clinicaltrials.gov/study/NCT05820841"}],"tags":["lymphoma-evidence"],"related":[],"cancers":["dlbcl","non-hodgkin-lymphoma"],"sections":["targeted-therapy","chemotherapy"],"technologies":[],"targets":["btk","cd20"],"drugs":["acalabrutinib","rituximab","cyclophosphamide","doxorubicin","vincristine","prednisone"],"companies":[],"institutions":[],"pathways":["bcr-signalling"],"terms":["r-chop","cell-of-origin"],"trials":["polar-bear"],"people":[],"bottlenecks":["b-aging-comorbidity","b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT05820841","phase":"3","setting":"Older adults with untreated diffuse large B-cell lymphoma: R-miniCHOP with or without acalabrutinib","sponsor":"Universität des Saarlandes","started":"2023-06-07","startedType":"actual","enrolled":330,"enrolledBasis":"registry","outcomes":[]},"route":"/trials/arched/","neighbours":{"cancer":[{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"targeted-therapy","kind":"section","name":"Targeted Therapy","route":"/fronts/targeted-therapy/"}],"target":[{"id":"btk","kind":"target","name":"BTK (Bruton tyrosine kinase)","route":"/targets/btk/"},{"id":"cd20","kind":"target","name":"CD20","route":"/targets/cd20/"}],"drug":[{"id":"acalabrutinib","kind":"drug","name":"Acalabrutinib","route":"/drugs/acalabrutinib/"},{"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":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"},{"id":"vincristine","kind":"drug","name":"Vincristine","route":"/drugs/vincristine/"}],"pathway":[{"id":"bcr-signalling","kind":"pathway","name":"B-cell receptor / BTK signalling (to NF-κB)","route":"/pathways/bcr-signalling/"}],"term":[{"id":"cell-of-origin","kind":"term","name":"Cell of origin (GCB vs ABC)","route":"/terms/cell-of-origin/"},{"id":"r-chop","kind":"term","name":"R-CHOP (lymphoma chemoimmunotherapy)","route":"/terms/r-chop/"}],"trial":[{"id":"phoenix","kind":"trial","name":"PHOENIX DDR/Anti-PD-L1","route":"/trials/phoenix/"},{"id":"polar-bear","kind":"trial","name":"POLAR BEAR","route":"/trials/polar-bear/"}],"bottleneck":[{"id":"b-aging-comorbidity","kind":"bottleneck","name":"Older and multimorbid patients are excluded and undertreated","route":"/bottlenecks/b-aging-comorbidity/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-schmitz-genetics-pathogenesis-dlbcl-nejm-2018","kind":"paper","name":"Genetics and pathogenesis of diffuse large B-cell lymphoma","route":"/key-papers/paper-schmitz-genetics-pathogenesis-dlbcl-nejm-2018/"},{"id":"paper-phoenix-ibrutinib-r-chop-non-gcb-dlbcl-jco-2019","kind":"paper","name":"Randomized phase III trial of ibrutinib and R-CHOP in non-germinal centre B-cell diffuse large B-cell lymphoma (PHOENIX)","route":"/key-papers/paper-phoenix-ibrutinib-r-chop-non-gcb-dlbcl-jco-2019/"}],"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/"}]}}