ClinicalTrials.gg
CompletedNCT03458260Updated Mar 10, 2026

Study of Pixantrone in CD20+ Relapsed/Refractory Aggressive Non-Hodgkin Lymphoma

A Phase 2 interventional study of Pixantrone and Ifosfamide in Aggressive Non-Hodgkin Lymphoma, sponsored by The Lymphoma Academic Research Organisation. Completed at 22 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-10.

Sponsored by The Lymphoma Academic Research Organisation · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
74
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This study will evaluate the efficacy of Pixantrone with rituximab, ifosfamide and etoposide as measured by the overall metabolic response rate after 2 cycles of treatment or at permanent treatment discontinuation.

Read the detailed description

This study will evaluate the efficacy of Pixantrone with rituximab, ifosfamide and etoposide as measured by the overall metabolic response rate after 2 cycles of treatment or at permanent treatment discontinuation.

02

Conditions studied

  • Aggressive Non-Hodgkin Lymphoma

Keywords

  • Diffuse Large B-Cell Lymphoma (DLBCL)
  • relapsed or refractory
03

In context

Lymphoma, Large B-Cell, Diffuse

1,868 studies on the registry are indexed under Lymphoma, Large B-Cell, Diffuse; 355 are open to participants now.

This study's enrollment of 74 is above the median of 45 across 1,497 interventional studies indexed under Lymphoma, Large B-Cell, Diffuse.

Browse Lymphoma, Large B-Cell, Diffuse studies →

Lead sponsor

The Lymphoma Academic Research Organisation is the lead sponsor of 60 studies on the registry; 12 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. proven CD20+ aggressive non-Hodgkin lymphoma (diffuse large B-cell lymphoma (DLBCL), de novo or transformed DLBCL from previously untreated low grade non-Hodgkin lymphoma or grade 3b follicular lymphoma) as per the World Health Organization (WHO) 2016 criteria
  2. disease, defined as follows:

    1. Patients eligible for who failed to achieve a Complete Response (CR) after at least one salvage therapy (eg, Rituximab-Etoposide- Methylprednisolone - Cytarabine - Cisplatin (R-ESHAP) or Rituximab- Dexamethasone- High-dose Cytarabine - Cisplatin (R-DHAP), patients who were previously refractory to Rituximab-Ifosfamide-Cytarabine-Etoposide (R-ICE) (stable disease or progressive disease) are not eligible to the study)
    2. Or patients in first relapse after Autologous Stem Cell Transplant (ASCT)
    3. Or patients not eligible for ASCT who failed to achieve a CR after at least one prior treatment (and no more than 4 previous lines) or in relapse after at least one prior treatment (and no more than 4 previous lines).
  3. Age > or =18 years
  4. (ECOG) performance status \< or = 2
  5. Subjects must have evaluable disease based on positron emission tomography (PET-CT) scan
  6. Minimum of 6 months
  7. Signed written
  8. Patient covered by any social security system
  9. Men must agree to use a barrier method of during the treatment period and until 6 months after the last dose of chemotherapy
  10. Women of must agree to use an adequate method of contraception, such as oral contraceptives, intrauterine device, or barrier method of contraception during the treatment period and until 12 months after the last dose of chemotherapy

Exclusion criteria

Exclusion Criteria:

  1. Any other histological type of lymphoma (Burkitt lymphoma, mantle-cell lymphoma…)
  2. Any history of previously treated indolent non-Hodgkin lymphoma
  3. Symptomatic central nervous system or meningeal involvement by the lymphoma
  4. to any drug contained in the Pixantrone with rituximab, ifosfamide and etoposide regimen
  5. Treatment with any drug within 28 days before the first study drug administration
  6. Any of the following lab abnormalities unless related to the lymphoma or bone marrow infiltration:

    1. (ANC) \< 1.0 G/L
    2. count \< 100 G/L
    3. \< 40 mL/min for patients \< 70 y, or creatinine clearance \< 60 mL/min for patients > or = 70 y, by Modification of Diet in Renal Disease () method.
    4. Total level > 1,5 x (ULN)
    5. Serum (AST) or ALanine Transaminase (ALT)> 2,5x ULN
  7. Known (HIV) positive
  8. Active virus (HCV) (Positive HCV serology with positive Polymerase Chain Reaction (PCR) for HCV RNA)
  9. Active (HB) :

    1. HBsAg positive
    2. HBsAg negative, Ac anti-HBs positive and/or Ac anti-HB core (HBc) positive (Patients who are seropositive due to a history of hepatitis B vaccine are eligible. Patients with Ac anti-HBs positive and/or Ac anti-HBc positive and no history of hepatitis B vaccine are eligible only if PCR for HB virus DNA is negative)
  10. Cumulative dose of doxorubicine or equivalent > 450mg/m2
  11. (LVEF) \< 50% measured by echocardiography or isotopic method
  12. Congestive heart failure (any stage from (NYHA) classification)
  13. Uncontrolled arterial hypertension
  14. Severe rhythmic heart disease
  15. Uncontrolled ischemic heart disease, including patients with stable angina
  16. Significant valvular heart disease
  17. History of a myocardial infarction within 6 months prior to enrolment
  18. Pregnant or lactating females
  19. Prior history of with the exception of non-melanoma skin tumors (basal cell or squamous cell carcinoma) or in situ cervical carcinoma
  20. Any serious active disease or co-morbid medical condition according to the investigator's decision
  21. Adult person unable to provide because of intellectual impairment, any serious medical condition, laboratory abnormality or psychiatric illness
  22. Use of any standard or experimental anti-cancer drug therapy within 28 days before the first study drug administration
  23. Use of prior to baseline PET-CT
  24. Person deprived of his/her liberty by a judicial or administrative decision
  25. Person hospitalized without consent
  26. Adult person under legal protection
Terms in these criteria, in plain language(24)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
74 participants (actual)

Study arms

  • Experimental
    Experimental

    Pixantrone plus rituximab, ifosfamide and etoposide.

    Drug: Pixantrone · Other: Ifosfamide · Other: Etoposide · Other: Rituximab · Procedure: Transplant

Interventions

  • 6 cycles - dose = 80mg/m²

    Also known as: Pixuvri

  • OtherIfosfamide

    6 cycles - 1500 mg/m2

    Also known as: Holoxan

  • OtherEtoposide

    6 cycles - 150 mg/m2

    Also known as: Vepeside

  • OtherRituximab

    6 cycles - 375 mg/m2

    Also known as: Mabthera

  • ProcedureTransplant

    after 2 or 6 cycles

06

What researchers measure

Primary outcomes

  1. Overall Metabolic Response rate (OMR) according to local investigator

    by local investigator according to Lugano classification 2014

    Time frame: After 42 days of treatment (2 cycles) or at permanent treatment discontinuation.

Secondary outcomes

  1. Complete Metabolic Response rate (CMR) according to local investigator

    according to local investigator

    Time frame: After 42 days of treatment (2 cycles of 21 days) or at permanent treatment discontinuation.

  2. Overall Metabolic Response rate (OMR) according to central review

    according to local investigator

    Time frame: After 42 days of treatment (2 cycles of 21 days) or at permanent treatment discontinuation.

  3. Complete Metabolic Response rate (CMR) according to central review

    according to local investigator

    Time frame: After 42 days of treatment (2 cycles of 21 days) or at permanent treatment discontinuation.

  4. Number of Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Number of Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Time frame: After 42 or 126 days of treatment (2 or 6 cycles of 21 days) or at permanent treatment discontinuation.

  5. Number of patients for whom Partial Metabolic Response (PMR) is transformed into CMR

    Number of patients for whom Partial Metabolic Response is transformed into CMR

    Time frame: After 42 days of treatment (2 cycles of 21 days) or at permanent treatment discontinuation.

  6. Rate of ASCT

    Number of patients who perform an ASCT out of total number of patients

    Time frame: After 42 days of treatment (2 cycles of 21 days) or at permanent treatment discontinuation.

  7. Success of stem cell collection after treatment

    Rate of successful stem cell collection

    Time frame: After 42 days of treatment (2 cycles of 21 days) or at permanent treatment discontinuation.

07

Study locations

22 sites
  • AZ Sint Jan
    Bruges, Belgium
  • Institut Jules Bordet - Centre des tumeurs de l'ULB
    Brussels, Belgium
  • Centre Hospitalier de Jolimont
    Haine-Saint-Paul, Belgium
  • CH d'Avignon
    Avignon, France
  • Centre Hospitalier de la Côte Basque
    Bayonne, France
  • CHU Jean Minjoz
    Besançon, France
  • Hôpital Haut-Lévèque
    Bordeaux, France
  • Centre Hospitalier William Morey
    Chalon-sur-Saône, France
  • Clinique Victor Hugo
    Le Mans, France
  • CHRU de Lille
    Lille, France
  • CHU Lyon Sud
    Lyon, France
  • CHU de la Conception
    Marseille, France
  • Centre Lacassagne
    Nice, France
  • Hopital La Pitié Salpétriere
    Paris, France
  • Hôpital St louis
    Paris, France
  • CHU de Poitiers
    Poitiers, France
  • Centre Hospitalier Annecy Genevois
    Pringy, France
  • CH de Cornouaille
    Quimper, France
  • Hôpital Robert Debré
    Reims, France
  • CHU de Rouen
    Rouen, France
  • CHU de Strasbourg
    Strasbourg, France
  • CHU de Tours
    Tours, France
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Dec 2018 to primary completion in Dec 2024, 71 months.

Of 210 non-industry phase 2 interventional studies under Lymphoma, Large B-Cell, Diffuse, half reached primary completion within 57 months of starting (the median), counting those still running; a quarter within 40 and three quarters within 96. This study's 71 months is above that.

Counting every sponsor, half of 264 studies reached it within 52 months; a quarter within 35 and three quarters within 85.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 26, 2018
First posted
Mar 8, 2018
StartActual
Dec 26, 2018
Primary completionActual
Dec 24, 2024
CompletionActual
Dec 24, 2024
Last update
Mar 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03458260
Lead sponsor
The Lymphoma Academic Research Organisation
Responsible party
Sponsor
First posted
Mar 8, 2018
Start date
Dec 26, 2018
Primary completion
Dec 24, 2024
Completion
Dec 24, 2024
Last update
Mar 10, 2026

Study contacts

Luc-Matthieu Fornecker
principal investigator · CHU de Strasbourg
Eric Van den Neste
principal investigator · UCL St Luc Bruxelles
Sandy Amorin
principal investigator · Hôpital St Louis - Paris

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Pixantrone

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