{"entity":{"id":"ielsg32","kind":"trial","name":"IELSG32","aka":["IELSG-32","MATRix trial"],"tldr":"IELSG32 built the MATRix regimen that is now the standard first treatment for lymphoma confined to the brain: adding rituximab and thiotepa to methotrexate and cytarabine doubled the complete remission rate, and its second part showed that a stem cell transplant works as well as whole-brain radiotherapy for consolidation, with less harm to thinking.","summary":"IELSG32 was an international randomised phase 2 trial in 227 patients with newly diagnosed primary CNS lymphoma. The first randomisation compared four courses of high-dose methotrexate and cytarabine alone (arm A), with rituximab (arm B), or with rituximab and thiotepa (arm C, the MATRix regimen). Patients with responsive or stable disease were then randomised to whole-brain radiotherapy of 36 Gy or high-dose carmustine and thiotepa with autologous stem cell transplant.\n\nComplete remission after induction was 49 percent with MATRix against 23 percent with methotrexate-cytarabine alone and 30 percent with rituximab added, with more grade 4 haematological toxicity but similar infections; 6 percent of patients died of toxicity. In the second randomisation two-year failure-free survival was 76 percent after radiotherapy and 75 percent after transplant, with cognitive function preserved after transplant and impaired attention and executive function after radiotherapy. The corpus's primary CNS lymphoma page cites IELSG32 for thiotepa-based chemotherapy with autologous transplant.","status":"positive","asOf":"2026-09-22","links":[{"label":"ClinicalTrials.gov NCT01011920","url":"https://clinicaltrials.gov/study/NCT01011920"}],"tags":["soc-trials"],"related":[],"cancers":["primary-cns-lymphoma","non-hodgkin-lymphoma","brain-tumours"],"sections":[],"technologies":["cytotoxic-chemotherapy","autologous-stem-cell-transplant"],"targets":[],"drugs":["methotrexate","cytarabine","thiotepa","rituximab","carmustine"],"companies":[],"institutions":["ielsg"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-ielsg32-matrix-induction-ferreri-lancet-haematol-2016","paper-ielsg32-wbrt-vs-asct-consolidation-ferreri-lancet-haematol-2017"],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT01011920","phase":"2","setting":"Newly diagnosed primary central nervous system lymphoma in immunocompetent patients aged 18 to 70: a first randomisation between high-dose methotrexate and cytarabine alone, with rituximab, or with rituximab and thiotepa (MATRix), and a second randomisation between whole-brain radiotherapy and carmustine-thiotepa conditioned autologous transplant as consolidation","sponsor":"International Extranodal Lymphoma Study Group (IELSG)","result":"Complete remission 49 percent with MATRix (methotrexate, cytarabine, thiotepa, rituximab) against 23 percent with methotrexate-cytarabine alone; two-year failure-free survival 76 percent after whole-brain radiotherapy and 75 percent after autologous transplant.","yearReported":2016,"enrolled":227,"enrolledBasis":"registry","outcomes":[{"endpoint":"Complete remission after induction chemotherapy","primary":true,"unit":"%","arms":[{"name":"MATRix: methotrexate, cytarabine, thiotepa, rituximab","value":49,"note":"95% CI 38 to 60; 219 of 227 assessable across the three arms"},{"name":"Methotrexate + cytarabine + rituximab","value":30,"note":"95% CI 21 to 42"},{"name":"Methotrexate + cytarabine","value":23,"note":"95% CI 14 to 31"}],"source":"https://doi.org/10.1016/S2352-3026(16)00036-3"},{"endpoint":"Failure-free survival at 2 years after the second randomisation","primary":true,"unit":"%","arms":[{"name":"Whole-brain radiotherapy 36 Gy with or without 9 Gy boost","value":76,"note":"95% CI 65 to 87"},{"name":"Carmustine-thiotepa conditioning and autologous stem cell transplant","value":75,"note":"95% CI 64 to 86"}],"source":"https://doi.org/10.1016/S2352-3026(17)30174-6"},{"endpoint":"Deaths from toxicity during induction","unit":"%","arms":[{"name":"All induction arms","n":219,"value":6}],"source":"https://doi.org/10.1016/S2352-3026(16)00036-3"}]},"route":"/trials/ielsg32/","neighbours":{"cancer":[{"id":"brain-tumours","kind":"cancer","name":"Brain and spinal cord tumours (all types)","route":"/cancers/brain-tumours/"},{"id":"non-hodgkin-lymphoma","kind":"cancer","name":"Non-Hodgkin lymphoma (all types)","route":"/cancers/non-hodgkin-lymphoma/"},{"id":"primary-cns-lymphoma","kind":"cancer","name":"Primary CNS lymphoma","route":"/cancers/primary-cns-lymphoma/"}],"technology":[{"id":"autologous-stem-cell-transplant","kind":"technology","name":"Autologous stem cell transplant (high-dose therapy)","route":"/technologies/autologous-stem-cell-transplant/"},{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"drug":[{"id":"carmustine","kind":"drug","name":"Carmustine","route":"/drugs/carmustine/"},{"id":"cytarabine","kind":"drug","name":"Cytarabine","route":"/drugs/cytarabine/"},{"id":"methotrexate","kind":"drug","name":"Methotrexate","route":"/drugs/methotrexate/"},{"id":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"},{"id":"thiotepa","kind":"drug","name":"Thiotepa","route":"/drugs/thiotepa/"}],"institution":[{"id":"ielsg","kind":"institution","name":"International Extranodal Lymphoma Study Group","route":"/institutions/ielsg/"}],"paper":[{"id":"paper-ielsg32-matrix-induction-ferreri-lancet-haematol-2016","kind":"paper","name":"IELSG32 first randomisation: the MATRix regimen (methotrexate, cytarabine, thiotepa, rituximab) in primary CNS lymphoma","route":"/key-papers/paper-ielsg32-matrix-induction-ferreri-lancet-haematol-2016/"},{"id":"paper-ielsg32-wbrt-vs-asct-consolidation-ferreri-lancet-haematol-2017","kind":"paper","name":"IELSG32 second randomisation: whole-brain radiotherapy or autologous stem cell transplant as consolidation in primary CNS lymphoma","route":"/key-papers/paper-ielsg32-wbrt-vs-asct-consolidation-ferreri-lancet-haematol-2017/"}]}}