First patients join major new lymphoma trial opening in Southampton
The REMoDL-A trial is being led by researchers at the Cancer Research UK Southampton Centre and the Southampton Clinical Trials Unit (SCTU) at the University of Southampton.
The trial will see if adding a targeted cancer drug called acalabrutinib to standard chemotherapy improves patient outcomes. It will give this to patients based on the genetic profile of their individual cancer.
Improving chemotherapy treatment
Around 5,500 people are diagnosed with diffuse large B cell lymphoma (DLBCL) each year in the UK. It develops when the body begins to make abnormal white blood cells. These build-up in the lymph nodes and prevent the body from dealing with infections in the normal way.
Standard treatment for DLBCL is a combination of chemotherapy drugs called R-CHOP3. Though this treatment works well for many people, some patients will not see a response. Others find it stops being effective and the lymphoma comes back.
Acalabrutinib works by blocking a protein which helps lymphoma cells to survive and grow, slowing the progression of the cancer.
A previous study in a small number of patients looked at the safety and optimal dose of acalabrutinib with R-CHOP for DLBCL.
The REMoDL-A trial will now build on this to test acalabrutinib in a larger number of people. It aims to see if it can improve the effectiveness of standard chemotherapy treatment.
Using the tumour’s genetic profile
The trial will recruit up to 558 patients with previously untreated DLBCL. Each will receive one round of R-CHOP chemotherapy. During this time blood and tumour samples will be used to determine the genetic make-up of their cancer.
Patients will then be randomly assigned to either continue receiving standard chemotherapy, or have chemotherapy and acalabrutinib.
Professor Andrew Davies, Professor of Haematological Oncology and chief investigator of the REMoDL-A trial said: “By looking at the molecular make-up of a patient’s lymphoma and then seeing how they respond to treatment, we hope to be able to determine whether adding acalabrutinib to standard chemotherapy improves outcomes for these patients, and whether people with different molecular profiles respond to the drug in different ways.
“This information could help us explore the best treatment options for individual patients and help lead to a more personalised approach to treating for DLBCL in the future.”
The study has recruited its first patients. It is now open at University Hospital Southampton, giving DLBCL patients across the south a chance to take part in the trial. Eventually it will open at 50 hospital sites across the UK.
A patient’s perspective
Jackie Rafferty from Southampton is a lymphoma patient. She is working with the team at the SCTU to make sure the patient voice is represented in decisions about how the REMoDL-A trial is conducted.
“I have a strong interest in any new treatments being researched,” says Jackie. “Although the REMoDL-A trial will not benefit me directly, I am only too pleased to be able to be involved in this study as a patient contributor.
“Hopefully the outcome of the all the lymphoma research being undertaken in Southampton will enable many people with different types of lymphoma to be cured or to live long lives with cancer.”
REMoDL-A is an independent, academic-led clinical trial which is being funded by an unrestricted educational grant from AstraZeneca.
The trial has endorsement from Cancer Research UK, allowing the trial team access to resources to assist in running the study, and with support from the NCRI Lymphoma Group.
Image: Professor Andrew Davies, chief investigator of the REMoDL-A trial