"I was delighted to take part in a clinical trial as it has the potential to really help others in the future.”
A study looking at chemotherapy and targeted therapy for lymphoma of the brain or spinal cord (TIER)
This study looked at combinations of cancer drugs for
This trial was open for people to join between 2015 and 2019. The team published the results in 2021.
More about this trial
CNS lymphoma is usually a type of non Hodgkin lymphoma called diffuse large B cell lymphoma (DLBCL). It is a high grade lymphoma. High grade lymphomas generally grow more quickly than low grade lymphomas.
Doctors often treat CNS lymphoma with chemotherapy. Sometimes the chemotherapy doesn’t work or the lymphoma comes back after treatment. In this situation there is no
The aims of the study were to:
- find the best dose of thiotepa
- see how well the combination of thiotepa, ifosfamide, etoposide and rituximab works for CNS lymphoma
- see what the side effects of the treatment are
Summary of results
The team found that they could give thiotepa with ifosfamide, etoposide and rituximab.
This was a
In phase 1 the first few people had a small dose of thiotepa with
ifosfamide, etoposide and rituximab. If all went well then the next few had a higher dose of thiotepa. And so on until the team found the best dose of thiotepa to give with ifosfamide, etoposide and rituximab.
In phase 2 everyone had this dose of thiotepa with ifosfamide, etoposide and rituximab.
The research team wanted to find out how well this combination had helped. To do this they looked at what the intention to treat was when people joined the trial. This is called an
Of these 14 people:
- there was no sign of the lymphoma in 9 (a complete response)
- the lymphoma had got better in 5 (a partial response)
The lymphoma had got worse in 4 people. This is called progressive disease.
The team were unable to include the remaining 9 people for a number of reasons. They include:
- leaving the trial
- stopping treatment due to side effects
The team looked at the length of time people lived without any sign of the lymphoma getting worse. They found it was from 2 months to 6 months.
They also looked at the length of time that people lived after treatment. They found it was from 3 months to 9 months.
The team looked at the worst side effects of treatment. The most common of these included:
- a drop in blood cells causing an increased risk of bruising, bleeding and infection
- a high temperature (fever) with a low number of white blood cells called
- fits (seizure)
- difficulty speaking
- low levels of phosphate, potassium, magnesium and albumin in the blood
- difficulty swallowing
The team concluded that thiotepa, ifosfamide, etoposide and rituximab can help people with CNS lymphoma:
- that has come back after treatment or
- when initial chemotherapy doesn’t work
However they say that for most people the outcome of treatment remains poor and new treatment plans are urgently needed.
Where this information comes from
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Professor Christopher Fox
Experimental Cancer Medicine Centre (ECMC)
University of Birmingham