Condition category
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status
Results overdue

Plain English Summary

Background and study aims
Non-Hodgkin’s lymphoma is a type of cancer that affects the network of vessels and glands throughout the body. We are comparing a drug called biosimilar rituximab against rituximab, both given with chemotherapy for patients with non-Hodgkin’s lymphoma. The main purpose of the study is to prove that the treatment with biosimilar rituximab has similar effects as the treatment with rituximab. Additionally, we will check the time taken for this disease to progress and review the safety of both drugs.

Who can participate?
The study aims to enrol 250 patients, men and women, aged 18 to 65, recently found to have this disease and who have not received any treatment for it before.

What does the study involve?
Patients are randomly allocated to one of two groups: one will be treated with biosmiliar rituximab and the other one with rituximab, both treatments combined with CHOP chemotherapy, on day 1 every 3 weeks for 6 cycles. There will be 3 study periods: screening (various tests will be done including a complete physical examination), treatment (visit the clinic every 3 weeks to undergo 6 cycles of treatment) and a final visit (30 days after completion of the treatment). After this, patients will be followed up every 3 months until 9 months after the last dose of chemotherapy.

What are the possible benefits and risks of participating?
Taking part in this study may or may not make your health better. This study might contribute to the development of a drug that will lower the cost of currently available treatment options. This information may help future patients. Patients may have side effects caused by the drug rituximab. The main ones are due to the drip (infusion of the drug) given during the treatment. These are mainly seen with the first drip and rarely require drug treatment to be stopped. Also, low blood pressure, fever, chills, episodes of shaking/shivering, skin rash, tightening of the airways and swelling of the deeper layers of the skin have been observed with this drug infusion. Possible serious side effects of CHOP chemotherapy include infection, bleeding problems, tissue injury, early menopause, heart failure and bladder problems. Common side effects of CHOP chemotherapy include nausea and vomiting, fevers and chills, skin rash, hair loss, mouth sores, fatigue, platelets in your blood may decrease (platelets help your blood clot if you cut yourself and you may bruise or bleed more easily than usual), severe constipation, numbness or tingling of fingers or toes, pink or reddish urine for 1-2 days after treatment, sugar control may be affected in people with diabetes, increased energy and difficulty sleeping.

Where is the study run from?
The study is run at different hospitals and clinics in Argentina, Brazil, Mexico, Venezuela, Paraguay, Indonesia, India, Colombia and South Africa.

When is the study starting and how long is it expected to run for?
The study started in January 2013 in Paraguay, April 2013 in Argentina, May 2013 in Indonesia and Mexico. It is expected that study will start in August 2013 in Brazil and South Africa and at the end of the year in Venezuela, India and Colombia. The study will be recruiting patients until December 2014.

Who is funding the study?
The present study is sponsored by mAbxience SA (Switzerland) and co-sponsors as this is a co-development study.

Who is the main contact?
Mrs Susana Millán, (English/Spanish)

Trial website

Contact information



Primary contact

Mrs Susana Millan


Contact details

Quintanapalla N2

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

A randomized, double-blind, phase III study comparing biosimilar rituximab (RTXM83) plus CHOP chemotherapy versus a reference rituximab plus CHOP (R-CHOP) in patients with Diffuse Large B-Cell Lymphoma (DLBCL) given as first line


Study hypothesis

The primary endpoint of the investigation is to determine if the response rate obtained with RXM83 combined with CHOP is non inferior to the response rate obtained with reference rituximab combined with CHOP
The present study is a non inferiority trial and the study hypothesis is the following: H0: pc ≥ pe + δ vs. H1: pc < pe + δ where,
pe: proportion of successes in the experimental group (RTXM83+CHOP)
pc: proportion of successes in the control group (Reference Rituximab+CHOP)
Type I error: the difference pc-pe is less than δ when in fact the difference is greater than or equal to δ ie, we choose the experimental treatment when the control treatment is actually substantially better.
Type II error: the difference -pe is greater than or equal to δ when it is actually lest than δ ie, we choose the control treatment when the experimental treatment is essentially just as good.

Ethics approval

─ 7-May-2012 – Ref No. NAP – Comité Independiente de Ética para Ensayos en Farmacología Clínica (FEFYM), Buenos Aires, Argentina
─ 31-May-2012 – Ref No. NAP – Consejo de Bioética. Sistema Provincial de Salud. Ministerio de Salud Pública de la Provincia de Tucumán, Argentina
─ 19-Jul-2012 – Ref No. HP-422 – Comité Institucional de Ética de Investigación en Salud – Hospital Privado-Centro Médico de Córdoba
─ 24-Oct-2012 – Ref No. 773/2012 – Comité de Ética de Investigación – Facultad de Ciencias Médicas – Universidad Nacional de Asunción, Asunción, Paraguay
─ 23-Jul-2012 – Ref No. 059/PEP/07/2012 – The Committee of the Medical Research Ethics of the “Dharmais” Cancer Hospital
─ 24-Jul-2012 - Ref No. 62340 - Ethic Committee of Faculdade de Ciencias Medicas – UNICAMP - Centro de Hematologia e Hemoterapia - HEMOCENTRO
─ 10-Sep-2012 – Ref No. NAP – Gobierno de la Ciudad de Buenos Aires Comité de Ética en Investigación Hospital General de Agudos Donación “Francisco Santojanni”
─ 13-Sep-2012 – Ref No. NAP – Comité de Ética Hospital Nacional de Clínicas Universidad Nacional de Córdoba
─ 02-Oct-2012 - Ref No. NAP – Comité de Ética del Centro Clínico San Cristóbal Hospital Privado, C.A., San Cristóbal, Táchira, Venezuela
─ 05-Oct-2012 – Ref No. NAP – Comité de Revisión Institucional del Hospital Británico
─ 05-Oct-2012-Ref No. NAP – Comité de Ética de la Clínica Dr. A.L. Briceño Rossi, Caracas, Distrito Capital, Venezuela
─ 07-Dec-2012 – Ref No. NAP – Comité Institucional de Ética Sanatorio Allende, Córdoba, Argentina
─ 20-Dec-2012– Ref No. NAP – Comité de Ética en Investigación – Universidad de Buenos Aires – Instituto de Oncología “Ángel H. Roffo”12-Feb-2013 – Ref No. 121111 – University of the Witwatersrand, Human Research Ethics Committee (HREC) and the Protocol Review Committee (PRC), Johannesburg, South Africa
─ 16-Feb-2013 – Ref No. 194.564 - Comissão Nacional de Ética em Pesquisa, Brasilia, Brazil

Study design

Prospective phase III multicenter double-blind randomized study

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Diffuse large b-cell lymphoma (DLBCL)


RTXM83 and Rituximab will be administered as : 375 mg/m2 I.V., every 3 weeks on Day 1 of the CHOP regimen, with a total of 6 cycles.

Intervention type



Phase III

Drug names


Primary outcome measure

Response Rate

Secondary outcome measures

1. To evaluate Event Free Survival (EFS) in both treatment arms
2. To evaluate Safety in both arms
3. To demonstrate comparable pharmacokinetics of RTXM83 and Rituximab
4. To demonstrate comparable pharmacodynamics
5. To compare immunogenicity between both arms

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Patients with measurable disease defined as existence of a unidimensional or bidimensional lesion greater than 2 cm in its longest diameter or malignant lymphocytosis greater than 5x109/L. Any other procedure for measurable disease in particular cases, may be allowed upon Sponsor approval
2. Newly diagnosed patients with a confirmed pathologic diagnosis of large B cell-non-Hodgkin’s lymphoma (DLBCL) with untreated CD20+. Defined by the local Haematopathologist at the local laboratory according to WHO criteria
3. Stage II-III or IV or stage I with bulk defined by the referring physician on the basis of the Cotswolds modification of the Ann Arbor classification 2
4. Age-adjusted International Prognostic Index (IPI) score 0 or 1
5. Age ≥18 to ≤65 years of age
6. Performance status (Eastern Cooperative Oncology Group [ECOG]) of ≤2
7. Written informed consent obtained before starting any study-specific procedure
8. Females of child-bearing potential must test negative on standard serum pregnancy test and must be willing to practice appropriate contraceptive methods for the duration of the study (e.g. oral contraceptive, double barrier method, intra-uterine device, intra-muscular contraceptive)
9. All male patients must take adequate contraceptive precautions during the course of the study

Participant type


Age group




Target number of participants


Participant exclusion criteria

1. Life expectancy of less than three months
2. Any other lymphoma other than CD20+ DLBCL
3. Indolent lymphoma, Primary central nervous system (CNS) Lymphoma or gastro-intestinal Mucosa Associated Lymphoid Tissue (MALT) Lymphoma
4. Known hypersensitivity to active ingredients, excipients and murine and foreign proteins
5. Concurrent disease or general status that would exclude giving the treatment as outlined in the protocol
6. Active uncontrolled infection requiring systemic treatment with antibiotics or antiviral agents at Screening or history of documented recurrent clinically significant infection (e.g. 2 or more viral, bacterial or fungal infections requiring inpatient treatment)
7. Cardiac contra-indication to Doxorubicin therapy: non-compensated heart failure, dilated cardiomyopathy, coronary heart disease with ST segment depression on electrocardiogram (ECG), myocardial infarction in the last 6 months
8. Neurologic contra-indication to Vincristine as it is indicated in the SmPC: (e.g. peripheral neuropathy)
9. Chronic lung disease with hypoxemia measured by saturometer (gasometry is not mandatory)
10. Severe uncontrolled hypertension, despite optimal medical treatment
11. Severe uncontrolled diabetes mellitus, despite optimal medical treatment
12. Renal insufficiency (Serum Creatinine>2xUNL)
13. Hepatic insufficiency (aspartate aminotransferase [AST]/alanine aminotransferase [ALT] >3xUNL or >5xUNL with involvement of the liver, total bilirubin >34.2 µmol/L, or both) not related to lymphoma
14. Clinical signs of cerebral dysfunction
15. Severe psychiatric disease
16. Known human immunodeficiency virus (HIV) infection or active chronic hepatitis B or C
17. Abnormal bone marrow function (platelets <100x109/L, neutrophils <1.5x109/L and Haemoglobin <9g/dL)
18. Post-transplantation lymphoproliferative disease
19. Pregnant or lactating women or women that intend to get pregnant during study or within 12 months following the last infusion
20. Treatment with any investigational product in the 30 days period before inclusion in the study
21. Prior radiotherapy to treat the DLBCL NHL
22. Limitation of the patient’s ability to comply with the treatment or follow-up protocol

Recruitment start date


Recruitment end date



Countries of recruitment

Argentina, Brazil, Colombia, India, Indonesia, Mexico, Paraguay, South Africa, Venezuela

Trial participating centre

Quintanapalla N2

Sponsor information


mAbxience (Switzerland)

Sponsor details

Yaguarón 1407 Oficina 904
Torre de los Profesionales
11 100

Sponsor type




Funder type


Funder name

A partnership has been established between mAbxience SA (Switzerland) and other pharmaceutical companies for the development of this large, phase III, multicentre clinical trial with this product, each company contributing to support the complete cost of the trial

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date


Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

Publication citations

Additional files

Editorial Notes

01/02/2019: Intention to publish date has been added