{"entity":{"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","aka":[],"tldr":"In the largest trial ever run in lymphoma of the brain, a stem cell transplant after MATRix chemotherapy kept 78 percent of patients free of progression at three years against 51 percent with conventional consolidation chemotherapy, and lengthened survival.","summary":"Randomised phase 3 trial in 368 patients aged 18 to 70 with newly diagnosed primary CNS lymphoma: after four cycles of MATRix, 230 patients with responding or stable disease were randomised to high-dose carmustine and thiotepa with autologous stem cell transplant or two cycles of R-DeVIC; 229 were analysed.\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, p 0.0003), and overall survival was also improved. Adverse events per patient were 14.6 against 9.3; fatal serious adverse events after consolidation occurred in five transplant patients (infections, pulmonary embolism) and two R-DeVIC patients (acute myeloid leukaemia).","asOf":"2026-09-22","links":[{"label":"Lancet 2026","url":"https://doi.org/10.1016/S0140-6736(26)00917-7"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/42486133/"}],"tags":[],"related":[],"cancers":["primary-cns-lymphoma"],"sections":[],"technologies":[],"targets":[],"drugs":["thiotepa","carmustine"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["ielsg43"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2026,"doi":"10.1016/S0140-6736(26)00917-7","pmid":"42486133","authors":"Illerhaus G, Ferreri AJM, Wendler J, et al.","paperType":"rct","findings":["Three-year progression-free survival 78 percent (95% CI 69 to 85) with transplant versus 51 percent (41 to 60) with R-DeVIC; hazard ratio 0.43 (0.27 to 0.68), p 0.0003.","Overall survival significantly improved with transplant.","Mean adverse events per patient 14.6 versus 9.3; five versus two fatal serious adverse events after consolidation."],"whatItMeans":"High-dose chemotherapy with autologous transplant is the preferred consolidation for fit patients with primary CNS lymphoma who complete MATRix induction.","caveats":["Only patients up to 70 who responded to induction and were fit for transplant were randomised; a third of enrolled patients never reached randomisation.","Transplant carried more toxicity, including fatal infections."],"changedPractice":true,"participants":368},"route":"/key-papers/paper-matrix-ielsg43-asct-consolidation-pcnsl-illerhaus-lancet-2026/","neighbours":{"cancer":[{"id":"primary-cns-lymphoma","kind":"cancer","name":"Primary CNS lymphoma","route":"/cancers/primary-cns-lymphoma/"}],"drug":[{"id":"carmustine","kind":"drug","name":"Carmustine","route":"/drugs/carmustine/"},{"id":"thiotepa","kind":"drug","name":"Thiotepa","route":"/drugs/thiotepa/"}],"trial":[{"id":"ielsg43","kind":"trial","name":"MATRix/IELSG43","route":"/trials/ielsg43/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}]}}