{"entity":{"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","aka":[],"tldr":"Adding rituximab and thiotepa to methotrexate and cytarabine doubled the complete remission rate for lymphoma confined to the brain, making the four-drug MATRix regimen the standard induction for patients up to 70.","summary":"First randomisation of the international phase 2 IELSG32 trial: 227 patients aged 18 to 70 with newly diagnosed primary CNS lymphoma were randomised to four courses of methotrexate and cytarabine alone, with rituximab, or with rituximab and thiotepa (MATRix).\n\nAt a median follow-up of 30 months the complete remission rate was 49 percent with MATRix against 23 percent with methotrexate-cytarabine alone (hazard ratio 0.46) and 30 percent with rituximab added (hazard ratio 0.61). Grade 4 haematological toxicity was more frequent with MATRix but infections were similar; 13 patients (6 percent) died of toxicity.","asOf":"2026-09-22","links":[{"label":"Lancet Haematol 2016","url":"https://doi.org/10.1016/S2352-3026(16)00036-3"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/27132696/"}],"tags":[],"related":[],"cancers":["primary-cns-lymphoma"],"sections":[],"technologies":[],"targets":[],"drugs":["methotrexate","cytarabine","thiotepa","rituximab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["ielsg32"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-haematology"],"dependsOn":[],"notes":[],"journal":"The Lancet Haematology","year":2016,"doi":"10.1016/S2352-3026(16)00036-3","pmid":"27132696","authors":"Ferreri AJ, Cwynarski K, Pulczynski E, et al.","paperType":"rct","findings":["Complete remission 49 percent (95% CI 38 to 60) with MATRix, 30 percent (21 to 42) with methotrexate-cytarabine-rituximab, 23 percent (14 to 31) with methotrexate-cytarabine.","Hazard ratio for complete remission 0.46 (0.28 to 0.74) for methotrexate-cytarabine alone against MATRix.","Toxic deaths 6 percent."],"whatItMeans":"MATRix became the reference induction for fit patients with primary CNS lymphoma and the control arm of later randomised trials.","caveats":["Randomised phase 2 design; the trial was not powered for survival.","Patients over 70 were excluded."],"changedPractice":true,"participants":227},"route":"/key-papers/paper-ielsg32-matrix-induction-ferreri-lancet-haematol-2016/","neighbours":{"cancer":[{"id":"primary-cns-lymphoma","kind":"cancer","name":"Primary CNS lymphoma","route":"/cancers/primary-cns-lymphoma/"}],"drug":[{"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/"}],"trial":[{"id":"ielsg32","kind":"trial","name":"IELSG32","route":"/trials/ielsg32/"}],"journal":[{"id":"lancet-haematology","kind":"journal","name":"The Lancet Haematology","route":"/journals/lancet-haematology/"}]}}