{"entity":{"id":"prima-cns","kind":"trial","name":"PRIMA-CNS","aka":["PRIMA-CNS trial","R-MP versus MARTA with transplant in elderly primary CNS lymphoma"],"tldr":"The first randomised trial asking whether older people with lymphoma of the brain do better with a short intensive course and a stem cell transplant than with the gentler long regimen that is standard in Germany.","summary":"Most people diagnosed with primary central nervous system lymphoma are 60 or older, and the two strategies used for them have never been compared head to head. The conventional approach, R-MP, gives rituximab with high-dose methotrexate and procarbazine, followed by procarbazine maintenance. The alternative, MARTA, gives a shorter induction of rituximab, high-dose methotrexate and cytarabine, followed by age-adjusted high-dose chemotherapy and autologous stem-cell transplantation; single-arm work has shown it feasible in selected elderly patients.\n\nPRIMA-CNS randomises 340 patients between them at German sites, with progression-free survival as the primary endpoint and primary completion estimated for 31 August 2029. The IELSG32 and MATRix/IELSG43 trials answered the consolidation question in younger patients; this is the same question for the age group that makes up most of the disease.\n\nThe trial's secondary endpoints matter more than usual here, because the treatments differ in neurotoxicity as well as in intensity, and cognitive outcome is the thing survivors of this disease live with.","status":"active","asOf":"2026-10-01","links":[{"label":"ClinicalTrials.gov NCT06830421","url":"https://clinicaltrials.gov/study/NCT06830421"}],"tags":["lymphoma-evidence"],"related":[],"cancers":["primary-cns-lymphoma","non-hodgkin-lymphoma"],"sections":["chemotherapy","cell-therapy"],"technologies":["cytotoxic-chemotherapy"],"targets":["cd20"],"drugs":["rituximab","methotrexate","procarbazine","cytarabine"],"companies":["ielsg"],"institutions":[],"pathways":[],"terms":["autologous-transplant","lymphoma-tx-transplant-role"],"trials":["ielsg32","ielsg43"],"people":[],"bottlenecks":["b-brain-delivery","b-aging-comorbidity","b-rare-cancers"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT06830421","phase":"3","setting":"Elderly patients with newly diagnosed primary central nervous system lymphoma: rituximab with high-dose methotrexate and procarbazine followed by procarbazine maintenance, against a short rituximab, methotrexate and cytarabine induction followed by age-adjusted high-dose chemotherapy with autologous stem-cell transplantation","sponsor":"University Hospital Freiburg","started":"2023-08-09","startedType":"actual","enrolled":340,"enrolledBasis":"registry","outcomes":[]},"route":"/trials/prima-cns/","neighbours":{"cancer":[{"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/"}],"section":[{"id":"cell-therapy","kind":"section","name":"Cell Therapy","route":"/fronts/cell-therapy/"},{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"target":[{"id":"cd20","kind":"target","name":"CD20","route":"/targets/cd20/"}],"drug":[{"id":"cytarabine","kind":"drug","name":"Cytarabine","route":"/drugs/cytarabine/"},{"id":"methotrexate","kind":"drug","name":"Methotrexate","route":"/drugs/methotrexate/"},{"id":"procarbazine","kind":"drug","name":"Procarbazine","route":"/drugs/procarbazine/"},{"id":"rituximab","kind":"drug","name":"Rituximab","route":"/drugs/rituximab/"}],"company":[{"id":"ielsg","kind":"company","name":"International Extranodal Lymphoma Study Group","route":"/companies/ielsg/"}],"term":[{"id":"autologous-transplant","kind":"term","name":"Autologous stem cell transplant (ASCT)","route":"/terms/autologous-transplant/"},{"id":"lymphoma-tx-transplant-role","kind":"term","name":"Stem cell transplant in lymphoma: what it is still for","route":"/terms/lymphoma-tx-transplant-role/"}],"trial":[{"id":"ielsg32","kind":"trial","name":"IELSG32","route":"/trials/ielsg32/"},{"id":"ielsg43","kind":"trial","name":"MATRix/IELSG43","route":"/trials/ielsg43/"}],"bottleneck":[{"id":"b-aging-comorbidity","kind":"bottleneck","name":"Older and multimorbid patients are excluded and undertreated","route":"/bottlenecks/b-aging-comorbidity/"},{"id":"b-rare-cancers","kind":"bottleneck","name":"Rare and paediatric cancers without markets","route":"/bottlenecks/b-rare-cancers/"},{"id":"b-brain-delivery","kind":"bottleneck","name":"The brain: barrier and sanctuary","route":"/bottlenecks/b-brain-delivery/"}],"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/"}]}}