A trial looking at inotuzumab ozogamicin for diffuse large B cell lymphoma (INCA)

Cancer type:

Blood cancers
High grade lymphoma
Non-Hodgkin lymphoma




Phase 2

This trial is looking at inotuzumab ozogamicin with R-CVP for diffuse large B cell lymphoma.


More about this trial

The standard treatment for diffuse large B cell lymphoma (DLBCL) is a combination of chemotherapy drugs and a monoclonal antibody called rituximab. This is called R-CHOP. Because one of the chemotherapy drugs can affect the heart, R-CHOP isn’t suitable for everyone. For people in this situation doctors usually give another drug combination called R-CVP. But this doesn’t work as well as R-CHOP. So doctors are looking for another drug to replace the one that affects the heart.

We know from research that adding the chemotherapy drug gemcitabine to R-CVP may work just as well for people who can’t have R-CHOP.

Inotuzumab ozogamicin (pronounced in-oh-too-zoo-mab oz-oh-ga-my-sin) is a monoclonal antibody. The researchers think that adding it to R-CVP may work for people who can’t have R-CHOP.

The aim of this trial is to compare gemcitabine and R-CVP with inotuzumab ozogamicin and R-CVP to find out which works best for people with diffuse large B cell lymphoma (DLBCL) who can’t have R-CHOP.

Who can enter

You may be able to enter this trial if you

  • Have diffuse large B cell lymphoma and your lymphoma cells make the CD20 protein (they are CD20 positive)
  • Have at least 1 area of lymphoma that can be measured on a scan
  • Are not able to have treatment with a chemotherapy drug from the anthracycline chemotherapy group Open a glossary item – your doctor can advise about this
  • Have satisfactory blood test results
  • Are well enough to be up and about for at least half the day (performance status 0, 1 or 2)
  • Are willing to use reliable contraception during treatment and for at least 1 year afterwards if there is any chance you or your partner could become pregnant
  • Are at least 18 years old

You cannot enter this trial if

  • Your lymphoma has spread to your brain or spinal cord and is causing symptoms
  • You had a previous diagnosis of a low grade lymphoma and you have had treatment that reaches the whole body (systemic therapy), such as chemotherapy
  • You had another cancer and are still having side effects from treatment or there is a 1 in 10 chance (10%) or more of your cancer coming back
  • You have had treatment for your lymphoma
  • You have problems with your liver
  • Your doctor thinks you may have a problem with alcohol
  • You are known to be HIV, hepatitis B or hepatitis C positive
  • You have had a bad reaction to other monoclonal antibodies
  • You have a serious infection
  • You are pregnant or breastfeeding

Trial design

This is a phase 2 trial. It will recruit 132 people. It is a randomised trial. The people taking part are put into treatment groups by a computer. Neither you nor your doctor will be able to choose which group you are in.

Before you are put into a treatment group, you may have been taking steroids. If your doctor thinks you are well enough you will be put into 1 of 2 treatment groups. If your doctor thinks you aren’t well enough you won’t take part in the trial.

People in group 1 will have gemcitabine, rituximab, cyclophosphamide, vincristine and prednisolone (Gem-R-CVP).

People in group 2 will have inotuzumab ozogamicin, rituximab, cyclophosphamide, vincristine and prednisolone (IO-R-CVP).

INCA trial diagram

You have gemcitabine, rituximab, cyclophosphamide, vincristine and inotuzumab ozogamicin as a drip into a vein. You have gemcitabine twice in 3 weeks and the other drugs once every 3 weeks. Each 3 week period is called a cycle of treatment.

Prednisolone is a tablet. You take it for the first 5 days of each cycle of treatment.

You have gemcitabine, cyclophosphamide, vincristine, inotuzumab ozogamicin and prednisolone for 6 cycles and rituximab for 8 cycles, as long as the treatment is helping you and the side effects aren’t too bad.

The trial team will ask you to fill out a questionnaire before you start treatment, after your 3rd treatment, at the end of treatment and at 6 months and 2 years after treatment. The questionnaire will ask about side effects and how you’ve been feeling. This is called a quality of life study.

They will also ask for extra blood samples and a sample of your lymphoma that was removed when you had a biopsy Open a glossary item. They will use these samples to find out more about diffuse large B cell lymphoma. 

Hospital visits

You see the doctor to have some tests before taking part in this trial. These tests include

During treatment you see the doctor twice every 3 weeks for a physical examination and blood tests. You have heart traces done every 3 weeks. You have a CT scan after 3 months.

At the end of treatment you see the doctor for the same tests as at the start, apart from the heart trace. You have a CT scan at the end of treatment, then after another 3 months and 1 year.

After treatment you see the doctor every 3 months for the 1st year, every 4 months for the 2nd year, every 6 months for the 3rd year and then every year after that.

Side effects

The most common side effects of inotuzumab ozogamicin are

Your doctor will talk to you about the possible side effects of treatment before you agree to take part in the trial.

We have information about gemcitabine, R-CVP and their side effects in our cancer drugs section.


Bury St Edmunds
Great Yarmouth
Newcastle upon Tyne

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Andrew McMillan

Supported by

Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
University College London (UCL)

Other information

This is Cancer Research UK trial number CRUKE/11/060.

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Charlie took part in a trial to try new treatments

A picture of Charlie

“I think it’s really important that people keep signing up to these type of trials to push research forward.”

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