Promising combo tackles aggressive lymphoma in large trial
NCT ID NCT04231448
First seen Jun 24, 2026 · Last updated Jun 27, 2026 · Updated 2 times
Summary
This Phase 3 trial tested whether adding tucidinostat (an oral HDAC inhibitor) to standard R-CHOP chemotherapy improves outcomes for people with newly diagnosed MYC/BCL2 double-expressor diffuse large B-cell lymphoma, an aggressive subtype. The study enrolled 423 adults who had not received prior treatment. Participants received either tucidinostat plus R-CHOP or a placebo plus R-CHOP for six cycles, with additional tucidinostat for those who achieved complete response. The main goal was to see if the combo extended event-free survival.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- tucidinostat (chidamide) plus R-CHOP chemotherapy
- What this could lead to
- If successful, this combination could become a new standard treatment for a hard-to-treat type of lymphoma, improving how long patients stay cancer-free.
- What could go wrong
- This is a completed Phase 3 trial, but results are not yet widely reported. Adding a drug may increase side effects, and the benefit over standard R-CHOP alone is not yet confirmed.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
-
Phase 3
Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.
- Participants
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423 people
The number who actually took part.
- Started
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May 2020
- Finished
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Jun 2025
- Lead sponsor
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A company
The lead sponsor is a pharmaceutical, biotech, or medical-device company.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 to 80 years
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Each potential subject must satisfy all of the following criteria to be enrolled in the study. 1. Male or female, age ≥ 18 years and ≤80 years. 2. No prior treatment for diffuse large B cell lymphoma(DLBCL), including hemotherapy, immunotherapy; radiotherapy (excluding local radiotherapy); monoclonal antibody therapy; surgical treatment (excluding biopsy) 3. Histological or cytological confirmation of DLBCL <!-- --> 1. CD20-positive DLBCL; 2. Myc≥40% as well as Bcl-2≥50% through immunohistochemistry; 3. Not with double (BCL-2 and c-MYC gene rearrangement) or triple (BCL-2, BCL-6, and c-MYC gene rearrangement) hit by FISH. The verification of DLBCL will be based on local pathology report.15-20 unstained slides must be sent to the central laboratory for retrospective confirmation. 4.At least one positive lesion according to the Lugano Classification by fluorodeoxyglucose (FDG) positron emission tomography (PET)-computed tomography(CT). 5.Lymphoma International PrognosisIndex (IPI) score of 2,3,4. 6.Eastern Cooperative Oncology Group performance status grade of 0, 1, or 2. 7.Laboratory criteria are as follows except that caused by lymphoma assessed by the investigator (without receiving any supportive treatment for the following parameters within 2 weeks from the last dose prior to study entry): (1)Hematology values:Hemoglobin (Hb)≥90g/L ; Absolute neutrophil count (ANC) ≥1.5×109/L ; platelets ≥90×109/L (2)Biochemical values: Serum creatinine ≤1.5×upper limit of normal(ULN); Total bilirubin ≤1.5 × ULN; Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) ≤2.5×ULN(ALT,AST≦5×ULN if liver involved). 8.Expected survival≥6 months. 9.All patients must have signed an informed consent document. Exclusion Criteria: * Any potential subject who meets any of the following criteria will be excluded from participating in the study. 1. Presence of CNS involvement. 2. Patients with primary DLBCL of the central nervous system (CNS),or secondary lymphoma of the central nervous system, or Primary mediastinal (thymic) large B-cell lymphoma, or Primary effusion lymphoma, or B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and classical Hodgkin lymphoma, or Primary cutaneous DLBCL, leg type, or indolent lymphoma, or Burkitt lymphoma, or EBV-positive mucocutaneous ulcer, or DLBCL associated with chronic inflammation, or Lymphomatoid granulomatosis, or Intravascular large B-cell lymphoma, or ALK-positive large B-cell lymphoma, or Plasmablastic lymphoma, or HHV8-positive DLBCL, NOS, or primary testicular DLBCL. 3. Patients with transformed lymphoma. 4. History of organ transplantation or hematopoietic stem cell transplantation. 5. Patients planned for autologous or allogeneic transplant as consolidation in first line. 6. Patients with any other malignancy, except patients with a history of curatively treated basal or squamous cell carcinoma or in situ carcinoma of the cervix at any time prior to the study are eligible. 7. Prior treatment with cytotoxic drugs for another condition (e.g., rheumatoid arthritis) or prior use of an anti-CD20 antibody within 5 years of the start of Cycle 1. 8. Prior use of any monoclonal antibody within 3 months of the start of Cycle 1. 9. Any investigational therapy within 3 months prior to the start of Cycle 1. 10. History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies or known sensitivity or allergy to murine products. 11. Contraindication to any of the individual components of CHOP. 12. Corticosteroid use \> 30 mg/day of prednisone or equivalent, for purposes other than lymphoma symptom control: <!-- --> 1. Patients receiving corticosteroid treatment with ≤ 30 mg/day of prednisone or equivalent must be documented to be on a stable dose of at least 4 weeks' duration prior to randomization (Cycle 1, Day 1). 2. If glucocorticoid treatment is urgently required for lymphoma symptom control prior to the start of study treatment, prednisone 100 mg or equivalent could be given for a maximum of 5 days, but all tumor assessments must be completed prior to start of glucocorticoid treatment. 13.Ongoing serious central nervous system disease or peripheral neuropathy, such as progressive multifocal leukoencephalopathy. 14.Have uncontrolled or significant cardiovascular disease, including: 1. Grade II or higher Congestive heart failure, unstable angina pectoris, myocardial infarction (New York Heart Association Functional Classification ) within 6 months prior to study entry; or arrhythmia requiring treatment, or Left Ventricular Ejection Fraction (LVEF) \< 50% during screening stage. 2. Primary cardiomyopathy (dilated cardiomyopathy, hypertrophic cardiomyocyte, arrhythmogenic right ventricular cardiomyopathy, restrictive cardiomyopathy, et,al). 3. History of significant QT interval prolongation, or Corrected QT Interval QTc≥450ms(male), QTc≥470ms(female)at screening. 4. Symptomatic coronary heart disease requiring treatment. 5. Any other cardiovascular disease which is inappropriate for the study according to investigators' judgment. 15.History of interstitial lung disease(ILD), or with ongoing signs and symptoms by CT or MRI at the time of screening. 16.Patients with factors that could affect oral medication (such as dysphagia, chronic diarrhea, intestinal obstruction etc), or undergone gastrectomy. 17.History of deep vein thrombosis or pulmonary embolism. 18.History of active bleeding within 2 months prior to the start of Cycle 1;or patients receiving anticoagulation therapy; or patients with evidence of bleeding potential according to investigators' judgment ( esophageal varices, active ulcer, or fecal occult blood test positive etc. ). Patients with bleeding led by lymphoma according to investigators' judgment are eligible. 19.6 weeks or less from the last major surgery that involved crucial organs, or with any other factors impede postoperative recovery according to investigators' judgment. 20.Known active infection, or active and uncontrolled hepatitis B infection(HBV), hepatitis C Virus(HCV), human immunodeficiency virus (HIV)/AIDS (Acquired Immune Deficiency Syndrome), or any other serious infection. (active infection defined as any major episode of infection requiring systemic treatment; Patients with occult or prior HBV may be included if HBV DNA is undetectable.) 21.Any mental or cognitive disorder, that would impair the ability to understand the informed consent document, or limit compliance with study requirements/ treatment. 22.Drug or alcohol abuse. 23.Women of childbearing potential and men who are sexually active not willing to practice a highly effective method of birth control during and after the study consistent with local regulations regarding the use of birth control methods for subjects participating in clinical trials.These restrictions apply for 12 months after the last dose of rituximab or 12 weeks after the last dose of study drug, whichever is later. Pregnancy or lactation. 24.Any other condition which is inappropriate for the study according to investigators' judgment.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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Peking University Cancer Hospital
Beijing, Beijing Municipality, China
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Shanghai JiaoTong University School of Medicine,Ruijin Hospital
Shanghai, Shanghai Municipality, China
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