
“I think it’s really important that people keep signing up to these type of trials to push research forward.”
This trial compared different ways of having rituximab alongside chemotherapy as the first treatment for diffuse large B cell lymphoma.
It was open for people to join between 2012 and 2016, and the research team published the results in 2017.
Diffuse large B cell lymphoma (DLBCL) is a type of non Hodgkin lymphoma.
Doctors often treat this type of lymphoma with R-CHOP. This is rituximab and a combination of chemotherapy drugs called CHOP.
Rituximab (Mabthera) is a type of immunotherapy called a monoclonal antibody. It helps the immune system recognise and kill lymphoma cells.
When this trial was done, the standard treatment for DLBCL was rituximab through a drip into a vein (intravenous treatment). In this trial, researchers compared this with rituximab as an injection just under the skin (a subcutaneous injection).
The aims of this trial were to find out if rituximab injections under the skin:
The research team found that there wasn’t much difference in how well the two ways of having rituximab worked for diffuse large B cell lymphoma. And
patients said having injections into the skin was better in some ways.
About this trial
This trial was for people with diffuse large B cell lymphoma (DLBCL) who hadn’t had any treatment yet.
Everyone taking part had CHOP chemotherapy. This is made up of the chemotherapy drugs cyclophosphamide, doxorubicin and vincristine, and the steroid prednisolone.
Everyone taking part also had rituximab. Some people had it through a drip into a vein (intravenous). And some people had it as an injection under the skin (subcutaneous).
Results
572 people had treatment as part of this trial. They were put into 1 of 2 treatment groups at random. They all had CHOP chemotherapy, and:
The research team looked at how well the treatment worked. They found that the lymphoma went away or got a bit better in:
They then looked at how many people’s lymphoma had not started to grow again after 3 years. It was more than 7 out of 10 (70%) in each group:
And when they looked at how many people were living, they found there wasn’t much difference between the 2 groups. It was more than 8 out of 10 (80%) in each group.
How long treatment took
People who had injections under the skin were at the hospital for less time than those who had the infusion into a vein.
The research team looked at how many people were at the hospital for 4 hours or more when they had their second dose of rituximab. They found it was:
Quality of life
The researchers asked the people who took part how having treatment affected their quality of life. They asked about things such as:
There wasn’t much difference between the two groups for most of these issues. But they were all a bit better for people who had rituximab as an injection under the skin (subcutaneous rituximab).
The biggest difference was the convenience and impact on daily life for people who had subcutaneous rituximab.
Side effects
About 9 out of 10 people (90%) in each group had at least one side effect. Many were mild or short lived. But more than 5 out of 10 people in each group had more severe side effects:
The most common side effects were a drop in red and white blood cells, extreme tiredness, feeling sick and hair loss.
We have more information about the side effects of R-CHOP in our Cancer Drugs section.
Conclusion
The trial team concluded that rituximab as an injection under the skin worked as well as a rituximab into the vein, and didn’t cause any more side effects. They also found people generally found treatment easier.
The team suggest that subcutaneous rituximab should be considered as a treatment option for diffuse large B cell lymphoma.
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 () and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Dr Andrew Hodson
NIHR Clinical Research Network: Cancer
Roche
Freephone 0808 800 4040
“I think it’s really important that people keep signing up to these type of trials to push research forward.”