ClinicalTrials.gg
Active, not recruitingNCT03463057HO151DLBCLUpdated Sep 23, 2026

The Feasibility and Clinical Efficacy of Atezolizumab Consolidation Treatment in High Risk (IPI > 2) DLBCL

A Phase 2 interventional study of Atezolizumab in NHL and DLBCL, sponsored by Stichting Hemato-Oncologie voor Volwassenen Nederland. Active, not recruiting at 32 sites in 2 countries. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-23.

Sponsored by Stichting Hemato-Oncologie voor Volwassenen Nederland · Phase 2, Interventional, and Treatment

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Phase
Phase 2
Study type
Interventional
Enrollment
109
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

The prognosis of Diffuse Large B cell Lymphoma (DLBCL) patients with an early relapse is dismal. Atezolizumab has shown promising activity in relapsed DLBCL patients. Toxicity data on atezolizumab are available for > 6000 patients and is manageable. The assumption of this study is that atezolizumab consolidation will result in higher disease free survival by eradicating minimal residual disease In melanoma and lung cancer consolidation immunotherapy after chemoradiotherapy has shown an increase in survival.

Read the detailed description

In high risk diffuse large B-cell lymphoma (DLBCL), International Prognostic Index (IPI)-score ≥ 3 21% of patients will relapse within 2-years after completion of R-CHOP induction treatment despite achieving a complete remission. Patient relapsing within a year after R-CHOP treatment have a very poor prognosis, even after second line chemotherapy, with only 15% of patients achieving a long remission. Therefore, additional therapy in first line treatment is required for these patients. The immune checkpoint inhibitor atezolizumab is a monoclonal antibody directed against the program death ligand 1 (PDL1). The PD1 and PDL1 inhibitors have shown excellent results in relapsed Hodgkin lymphoma and promising results in relapsed B-cell non Hodgkin lymphoma. Given the acceptable toxicity profile of atezolizumab, this study examines the efficacy and toxicity of atezolizumab as consolidation treatment after R-CHOP induction in DLBCL patients at high risk of relapse.

02

Conditions studied

  • NHL
  • DLBCL
03

In context

Lead sponsor

Stichting Hemato-Oncologie voor Volwassenen Nederland is the lead sponsor of 27 studies on the registry; 11 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 75 Years
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

  • Age 18-75 (inclusive) years
  • Patients with a confirmed histologic diagnosis of diffuse large B-cell lymphoma (DLBCL-NOS) based upon a representative histology specimen according to the World Health Association (WHO) classification, revision 2016
  • Ann Arbor stages II-IV
  • 0 - 1
  • International Prognostic Index (IPI) ≥ 3 at diagnosis
  • Complete metabolic remission (Deauville 1-3) after 6-8 cycles of R-CHOP according to the Lugano criteria

Of note:

  1. Rituximab may have been administered either intravenously or subcutaneously. A rituximab biosimilar may have been used when it is approved for the indication of DLBCL.
  2. Patients should have received at least 6 cycles R-CHOP. Dose reductions for vincristine are allowed during R-CHOP. Dose reductions because of bone marrow toxicity are allowed but cannot exceed >15% of cumulative dose of doxorubicin and cyclophosphamide.
  3. Central nervous system prophylaxis (MTX) by intrathecal therapy or IV is allowed.
  4. Fludeoxyglucose Positron Emission Tomography (18F-FDG-PET) scan should have been made 4-8 weeks after last induction cycle
  5. confirmed false positive EoT PET-scans are eligible.

    • Negative pregnancy test at study entry
    • Patient is willing and able use adequate during and until 5 months after the last protocol treatment.
    • Patient is capable of giving a written

Exclusion criteria

Exclusion Criteria:

Diagnosis

  • All histopathological diagnoses other than DLBCL-NOS according to the WHO classification, revision 2016, including:

- High-grade B-cell lymphoma with a double/triple translocation with MYC, BCL2 and/or BCL6. Please note that patients with an isolated MYC translocation or an isolated BCL2 translocation or an isolated BCL-6 translocation are eligible (single hit translocation).

  • Testicular large B-cell lymphoma
  • Primary mediastinal B cell lymphoma
  • Transformed indolent lymphoma
  • Post-transplant lymphoproliferative disorder

Organ dysfunction

  • Clinical signs of severe pulmonary dysfunction
  • Clinical signs of heart failure ( (NYHA) classification II-IV)
  • Symptomatic coronary artery disease or cardiac arrhythmias not well controlled with medication.
  • Myocardial infarction during the last 6 months
  • Significant renal dysfunction (serum creatinine ≥ 150 umol/l or clearance ≤ 30ml/min

(CrCl) may be calculated by Cockcroft -Gault formula:

CrCl = (140 - age [in years]) x weight [kg] (x 0.85 for females)/(0.815 x serum creatinine [μmol/L])

  • Inadequate hematological function: \< 5.5 mmol/L (ANC) \< 1.0x10↑9/L or \< 75x10↑9 /L
  • Signs or known history of bleeding disorder.
  • Significant hepatic dysfunction (total ≥ 1.5x (ULN) or transaminases ≥ 2.5 x ULN), unless related to Gilberts syndrome.
  • Clinical signs of severe cerebral dysfunction
  • Patients with a history of uncontrolled seizures, central nervous system disorders or psychiatric disability judged by the investigator to be and adversely affecting compliance to study drugs
  • Major surgery within the last 4 weeks

Known or suspected infection • Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection or any major episode of infection requiring treatment with IV antibiotics or hospitalization within 4 weeks of the start of Cycle 1. Suspected active or latent tuberculosis needs to be confirmed by positive interferon gamma (IFN-γ) release assay

  • Patients known to be Human Immuno-deficiency Virus ()-positive
  • Active chronic or C infection
  • Administration of a live, attenuated vaccine within 4 weeks before date of registration or anticipation that such a will be required during the study and for a period of 5 months after discontinuation of atezolizumab

Auto-immune • Any active or history of documented disease, including but not limited to myasthenia gravis, myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, vascular thrombosis associated with antiphospholipid syndrome, Wegener's granulomatosis, Sjögren's syndrome, Guillain-Barré syndrome, multiple sclerosis, vasculitis, or glomerulonephritis.

The following exceptions are allowed: Patients with autoimmune-related hypothyroidism or type 1 diabetes mellitus who are on stable treatment.

  • History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis per chest computer tomography (CT) scan at screening.
  • Patients with uncontrolled asthma or allergy, requiring systemic treatment
  • Regular treatment with corticosteroids within the 4 weeks prior to date of registration, unless administered for indications other than NHL at a dose equivalent to \< 30 mg/day prednisone/prednisolone

General

  • Serious underlying medical conditions, which could impair the ability of the patient to participate in the trial (e.g. ongoing infection, uncontrolled diabetes mellitus, gastric ulcers, active autoimmune disease)
  • Current participation in another clinical trial interfering with this trial
  • History of active cancer during the past 5 years, except basal cell carcinoma of the skin, stage 0 cervical carcinoma or carcinoma in situ (for which no systemic treatment was indicated)
  • \< 6 months
  • Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule

Prior treatment

  • Prior treatment with Atezolizumab, or anti-programmed cell death protein-1 (anti ) or PDL-1 antibodies.
  • Prior treatment with CD137 agonists or immune checkpoint blockade therapies, including anti-CTLA4 therapeutic antibodies.
  • Treatment with systemic immunostimulatory agents (including but not limited to IFN, interleukin [IL]-2) within 6 weeks or 5 half-lives of the drug, whichever is shorter, prior to Cycle 1, Day 1.
  • Treatment with systemic medications, including but not limited to prednisone, cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor (anti-TNF) agents within 2 weeks prior to date of registration; inhaled corticosteroids and mineralocorticoids are allowed.
Terms in these criteria, in plain language(20)

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.

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.

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.

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.

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.

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.

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

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.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

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 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.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. 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.

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.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

05

Study design

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

Study arms

  • Other
    Atezolizumab

    18 cycles atezolizumab followed by 12 months of observation

    Drug: Atezolizumab

Interventions

  • Intervention Atezolizumab starts after 6 - 8 R-CHOP induction cycles (Rituximab, Cyclophosphamide, Hydroxo-doxorubicin, Vincristine and Prednisone (R-CHOP)); 18 cycles Atezolizumab followed by 12 months of observation

    Also known as: Tecentriq, L01XC

06

What researchers measure

Primary outcomes

  1. Disease free survival (DFS) measured from the date of registration to relapse or death from any cause whichever comes first.

    To evaluate the 2-year DFS for patients in complete metabolic remission after R-CHOP induction

    Time frame: 2 year after inclusion last patient

Secondary outcomes

  1. (Severe) Adverse Events and the relation of adverse events in time to the recovery of the T-cell repertoire.

    To evaluate toxicity and assess the relation of adverse events in time to recovery of the T-cell repertoire.

    Time frame: 2 years after inclusion last patient

  2. Overall survival (OS), calculated from registration until death from any cause. Patients still alive or lost to follow up are censored at the last date known to be alive.

    To evaluate the 2-year OS.

    Time frame: 2 years after inclusion last patient

  3. The relationship between MRD status at the end-of-induction and end-of-consolidation therapy.

    To evaluate MRD status at the end of induction therapy, at various time points during consolidation treatment and at the end of consolidation.

    Time frame: 2 years after inclusion last patient

  4. The relation between MRD conversion and 2-years DFS and OS.

    To evaluate if there is a relation between MRD conversion and 2-years DFS and OS.

    Time frame: 2 years after inclusion last patient

  5. The relation between the T-cell and NK cell repertoire and adverse events.

    To evaluate the recovery of the T-cell and NK cell repertoire after induction therapy and at various time points during consolidation treatment in relation to toxicity and efficacy.

    Time frame: 2 years after inclusion last patient

Other outcomes

  1. Atezolizumab spinal fluid concentration as assessed by spinal fluid measurements will be performed in patients receiving atezolizumab.

    To assess the crossing of the blood-brain barrier of atezolizumab by measuring atezolizumab concentrations in het cerebrospinal fluid.

    Time frame: 2 years after inclusion last patient

07

Study locations

32 sites
08

References and documents

Publications

  • Nijland M, Issa DE, Bult JAA, Deeren D, Velders GA, Nijziel MR, Sandberg Y, Vergote V, Oosterveld M, Fijnheer R, Brouwer RE, Boersma RS, Wu K, Nieuwenhuizen L, Vermaat JSP, van Kampen RJW, Terpstra WE, Snauwaert S, van der Poel MW, de Jongh E, Durian MF, Strobbe L, Beeker A, Gadisseur A, van Rijn RS, Visser O, Doorduijn JK, Snijders TJF, Silbermann MH, de Jong D, Chamuleau M, Mous R, Jalving H, Visser-Wisselaar H, Jansen van de Bergh S, Zwezerijnen GJC, Bremer E, Brink M, Diepstra A, Chitu DA, Koene HR, Zijlstra JM. Atezolizumab consolidation in patients with high-risk diffuse large B-cell lymphoma in complete remission after R-CHOP. Blood Adv. 2025 Jul 22;9(14):3530-3539. doi: 10.1182/bloodadvances.2024015226. PubMed 40249860 ↗

Related links

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Aug 2018 to primary completion in Jan 2024, 64 months.

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

Registered
Feb 23, 2018
First posted
Mar 13, 2018
StartActual
Aug 30, 2018
Primary completionActual
Jan 18, 2024
CompletionEst.
Jan 2027
Last update
Sep 23, 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 Sep 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03463057
Lead sponsor
Stichting Hemato-Oncologie voor Volwassenen Nederland
Responsible party
Sponsor
First posted
Mar 13, 2018
Start date
Aug 30, 2018
Primary completion
Jan 18, 2024
Completion
Jan 2027 (estimated)
Last update
Sep 23, 2026

Study contacts

M. Nijland, PhD/MD
principal investigator · NL-Groningen-UMCG

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 active, not recruiting, as verified in Sep 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: Atezolizumab

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