{"entity":{"id":"ielsg43","kind":"trial","name":"MATRix/IELSG43","aka":["IELSG43","IELSG-43","MATRix"],"tldr":"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.","summary":"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.\n\nAt 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.","status":"positive","asOf":"2026-09-22","links":[{"label":"ClinicalTrials.gov NCT02531841","url":"https://clinicaltrials.gov/study/NCT02531841"}],"tags":["soc-trials"],"related":[],"cancers":["primary-cns-lymphoma","non-hodgkin-lymphoma","brain-tumours"],"sections":[],"technologies":["autologous-stem-cell-transplant","cytotoxic-chemotherapy"],"targets":[],"drugs":["thiotepa","carmustine","rituximab","methotrexate","cytarabine","etoposide","ifosfamide","carboplatin"],"companies":[],"institutions":["ccc-freiburg","ielsg"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-matrix-ielsg43-asct-consolidation-pcnsl-illerhaus-lancet-2026"],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT02531841","phase":"3","setting":"Newly diagnosed primary central nervous system lymphoma in patients up to 70 responding to four cycles of MATRix induction: consolidation with high-dose carmustine and thiotepa and autologous stem cell transplant against two cycles of non-myeloablative rituximab, dexamethasone, etoposide, ifosfamide and carboplatin (R-DeVIC)","sponsor":"University Hospital Freiburg","result":"Three-year progression-free survival 78 percent after high-dose chemotherapy and autologous transplant against 51 percent after non-myeloablative R-DeVIC (hazard ratio 0.43, p 0.0003), with better overall survival and more toxicity.","yearReported":2026,"enrolled":368,"enrolledBasis":"registered","enrolledNote":"The registry gives an estimated 250 and was not updated; the Lancet report enrolled 368 patients, 346 started induction and 230 were randomised (229 analysed).","outcomes":[{"endpoint":"Progression-free survival at 3 years","primary":true,"unit":"%","arms":[{"name":"High-dose carmustine-thiotepa and autologous stem cell transplant","n":114,"value":78,"note":"95% CI 69 to 85; median follow-up 45.3 months"},{"name":"R-DeVIC non-myeloablative consolidation","n":115,"value":51,"note":"95% CI 41 to 60"}],"hr":0.43,"ci":[0.27,0.68],"p":"0.0003","source":"https://doi.org/10.1016/S0140-6736(26)00917-7"},{"endpoint":"Mean adverse events per patient","arms":[{"name":"High-dose carmustine-thiotepa and autologous stem cell transplant","n":114,"value":14.6},{"name":"R-DeVIC non-myeloablative consolidation","n":115,"value":9.3}],"source":"https://doi.org/10.1016/S0140-6736(26)00917-7"},{"endpoint":"Fatal serious adverse events after consolidation","unit":"participants","arms":[{"name":"High-dose carmustine-thiotepa and autologous stem cell transplant","n":114,"value":5},{"name":"R-DeVIC non-myeloablative consolidation","n":115,"value":2}],"source":"https://doi.org/10.1016/S0140-6736(26)00917-7"}]},"route":"/trials/ielsg43/","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":"carboplatin","kind":"drug","name":"Carboplatin","route":"/drugs/carboplatin/"},{"id":"carmustine","kind":"drug","name":"Carmustine","route":"/drugs/carmustine/"},{"id":"cytarabine","kind":"drug","name":"Cytarabine","route":"/drugs/cytarabine/"},{"id":"etoposide","kind":"drug","name":"Etoposide","route":"/drugs/etoposide/"},{"id":"ifosfamide","kind":"drug","name":"Ifosfamide","route":"/drugs/ifosfamide/"},{"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":"ccc-freiburg","kind":"institution","name":"Comprehensive Cancer Center Freiburg (CCCF)","route":"/institutions/ccc-freiburg/"},{"id":"ielsg","kind":"institution","name":"International Extranodal Lymphoma Study Group","route":"/institutions/ielsg/"}],"paper":[{"id":"paper-matrix-ielsg43-asct-consolidation-pcnsl-illerhaus-lancet-2026","kind":"paper","name":"MATRix/IELSG43: high-dose chemotherapy and autologous stem cell transplant versus non-myeloablative consolidation in primary CNS lymphoma","route":"/key-papers/paper-matrix-ielsg43-asct-consolidation-pcnsl-illerhaus-lancet-2026/"}]}}