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DLBCL - Diffuse Large B Cell LymphomaPhase 3MOD-DHAPNCT07739654

Modified DHAP Versus Standard DHAP in Relapsed/Refractory Diffused Large B-cell Lymphoma.

A Phase 3 study testing Cisplatin (modified schedule), Cisplatin and Dexametasone in people with DLBCL - Diffuse Large B Cell Lymphoma, run by King Edward Medical University at 1 site in Pakistan.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This Phase III randomized controlled trial evaluates the effectiveness and toxicity profile of a modified DHAP regimen compared to the standard DHAP regimen in adult patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
DLBCL - Diffuse Large B Cell Lymphoma
What is being tested?
Cisplatin (modified schedule), Cisplatin and Dexametasone
Could I receive a placebo?
No, everyone receives an active treatment
How many people
74 participants
Where
1 sitePakistan
Study dates
18 Mar 2026to 20 Oct 2027
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Histologically confirmed relapsed or refractory DLBCL
  • Adults ≥ 18 years
  • At least one prior line of therapy for lymphoma
  • ECOG performance status 0-2
  • Ability to provide informed consent and comply with study requirements
  • Adequate organ function:
Show all 9Show fewer
  • Hematologic: ANC ≥ 1,000 cells/mm³, Platelets ≥ 75,000 cells/mm³
  • Renal: Serum creatinine ≤ 1.5 × ULN
  • Hepatic: Total bilirubin ≤ 1.5 × ULN, AST/ALT ≤ 2.5 × ULN (if no liver metastases)

Who cannot join

  • History of other malignancies within last 5 years (except non-melanoma skin cancer or localized prostate cancer)
  • Pregnant or breastfeeding women
  • Significant uncontrolled medical conditions (e.g., cardiovascular disease, uncontrolled diabetes)
  • Receipt of investigational agents within 30 days prior to enrollment
  • Known severe allergic reactions to DHAP components (dexamethasone, cytarabine, cisplatin)
  • Concurrent anti-cancer treatments (chemotherapy, radiotherapy) during study period

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Inbsaat Iqbal, MBBS, MD contact

+923099533745

inbsatiqbal56@gmail.com

Hafiz Muhammad Ehsan Arshad, MBBS contact

+923349830727

ehsanarshadch@gmail.com

Pakistan1 site, 1 recruiting
  • Mayo Hospital

    Lahore, Punjab Province, 54000

    Inbsaat Iqbal, MBBS, MD, 03099533745, inbsatiqbal56@gmail.com

    inbsatiqbal56@gmail.com

    Recruiting

Other trials in Pakistan

About this study

Official title: Comparison of Effectiveness and Toxicities of Modified DHAP Protocol With Standard DHAP Protocol in Patients With Relapsed/Refractory Diffused Large B-cell Lymphoma.

This Phase III randomized controlled trial evaluates the effectiveness and toxicity profile of a modified DHAP regimen compared to the standard DHAP regimen in adult patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). The DHAP regimen (cisplatin, cytarabine, dexamethasone) is widely used as salvage therapy but is associated with significant toxicities, including renal dysfunction and severe myelosuppression. The modified DHAP protocol fractionates cisplatin and cytarabine administration to reduce nephrotoxicity, improve tolerability, and potentially allow outpatient treatment.

A total of 74 patients will be randomized (37 per arm) to receive either the modified or standard DHAP regimen. The primary endpoint is overall response rate (ORR) assessed by RECIL 2017 criteria. Secondary endpoints include progression-free survival (PFS), toxicity incidence and severity graded by CTCAE, and quality of life measured by EORTC QLQ-C30.

The study anticipates that the modified DHAP regimen will demonstrate comparable or superior efficacy with reduced severe toxicities, shorter hospital stays, and improved patient satisfaction. Findings may support transitioning DHAP into outpatient administration, optimizing healthcare resource utilization in Pakistan.

Read the detailed description

This study is a randomized controlled trial designed to compare the effectiveness and toxicity profile of a modified DHAP regimen versus the standard DHAP regimen in adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

DLBCL is the most common subtype of non-Hodgkin lymphoma, with a significant proportion of patients experiencing relapse or refractory disease after initial therapy. The standard DHAP regimen (cisplatin, cytarabine, dexamethasone) has been widely used as salvage therapy, achieving response rates of up to 70%. However, its use is limited by severe toxicities, including renal dysfunction, infections, and profound myelosuppression.

The modified DHAP regimen alters the administration schedule of cisplatin and cytarabine. Cisplatin is fractionated into smaller doses over multiple days rather than a single 24-hour continuous infusion, and cytarabine is administered over two consecutive days. This modification is hypothesized to reduce nephrotoxicity, improve tolerability, and allow outpatient administration, while maintaining or enhancing cytotoxic synergy between cisplatin and cytarabine.

A total of 74 patients will be enrolled and randomized into two arms (37 per arm):

  • Arm A (Modified DHAP): Dexamethasone 40 mg PO/IV days 1-4; Cisplatin 50 mg/m² over 6 hours days 1-2; Cytarabine 2 g/m² IV over 3 hours days 1-2.
  • Arm B (Standard DHAP): Dexamethasone 40 mg PO/IV days 1-4; Cisplatin 100 mg/m² continuous infusion over 24 hours day 1; Cytarabine 2×2 g/m² IV over 3 hours day 2.

Primary endpoint: Overall response rate (ORR), defined as complete or partial response per RECIL 2017 criteria.

Secondary endpoints: Progression-free survival (PFS), toxicity incidence and severity graded by CTCAE, and quality of life (QoL) assessed using the EORTC QLQ-C30 questionnaire.

Patients will be followed for treatment response, adverse events, and QoL changes. Toxicities will be documented using CTCAE forms, with particular attention to hematological toxicities (anemia, neutropenia, thrombocytopenia) and non-hematological toxicities (renal dysfunction, hepatotoxicity, mucositis, neuropathy).

The study anticipates that the modified DHAP regimen will demonstrate comparable or superior efficacy with a reduced incidence of severe toxicities, shorter hospital stays, and improved patient satisfaction. If successful, this regimen could support the transition of DHAP into outpatient administration, optimizing healthcare resource utilization in Pakistan and improving access to therapy for patients with poor prognoses.

Being tested
Cisplatin (modified schedule), Cisplatin, Dexametasone, Cytarabine (Ara-C), Cytarabine (Ara-C) (Modified schedule)
Keywords
DLBCL, DHAP, B cell Lymphoma
Medical subject headings
Dendritic Cell Sarcoma, Interdigitating, Lymphoma, B-Cell

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cisplatin (modified schedule)Drug

    The modified DHAP regimen alters the administration schedule of cisplatin and cytarabine. Cisplatin is fractionated into smaller doses over multiple days rather than a single 24-hour continuous infusion.

  • CisplatinDrug

    The standard DHAP regimen defined as follows:

    • Dexamethasone: 40 mg orally or intravenously, given daily on days 1-4
    • Cisplatin: 100 mg/m² administered intravenously as a continuous infusion over 24 hours on day 1
    • Cytarabine: 2 × 2 g/m² intravenously over 3 hours, given on day 2 (two doses, 12 hours apart) This cycle is repeated every 21 days for 2-4 cycles, depending on patient tolerance and response.
  • DexametasoneDrug

    Also called Dexa

    The standard dexamethasone dosing regimen per RECIL 2017 criteria

  • Cytarabine (Ara-C)Drug

    Also called Ara-C

    The standard DHAP regimen defined as follows:

    • Dexamethasone: 40 mg orally or intravenously, given daily on days 1-4
    • Cisplatin: 100 mg/m² administered intravenously as a continuous infusion over 24 hours on day 1
    • Cytarabine: 2 × 2 g/m² intravenously over 3 hours, given on day 2 (two doses, 12 hours apart) This cycle is repeated every 21 days for 2-4 cycles, depending on patient tolerance and response.
  • Cytarabine (Ara-C) (Modified schedule)Drug

    The modified DHAP regimen alters the administration schedule of cisplatin and cytarabine. Cytarabine is administered over two consecutive days.

Study groups in NCT07739654
Study groupRoleWhat they receive
Modified DHAPExperimentalDexamethasone 40 mg PO/IV days 1-4; Cisplatin 50 mg/m² over 6 hours days 1-2; Cytarabine 2 g/m² IV over 3 hours days 1-2.
Receives: Drug: Cisplatin (modified schedule); Drug: Dexametasone; Drug: Cytarabine (Ara-C) (Modified schedule)
standard DHAPActive comparatorDexamethasone 40 mg PO/IV days 1-4; Cisplatin 100 mg/m² continuous infusion over 24 hours day 1; Cytarabine 2×2 g/m² IV over 3 hours day 2.
Receives: Drug: Cisplatin; Drug: Dexametasone; Drug: Cytarabine (Ara-C)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Response rate (ORR)

    The Overall Response Rate (ORR) is defined as the percentage of patients achieving either a Complete Response (CR) or a Partial Response (PR), assessed according to RECIL 2017 criteria.

    • Complete Response (CR):
    • Disappearance of all target lesions
    • Lymph nodes <10 mm
    • Normalization of FDG-PET (Deauville 1-3)
    • No bone marrow involvement, no new lesions
    • Partial Response (PR):
    • ≥30% decrease in the sum of longest diameters of target lesions
    • FDG-PET positive (Deauville 4-5)
    • May still have bone marrow involvement
    • No new lesions

    Measured: From enrollment to the end of treatment at 12 weeks

Secondary outcomes (8)
  1. Complete Response (CR)

    • Complete Response (CR):
    • Disappearance of all target lesions
    • Lymph nodes <10 mm
    • Normalization of FDG-PET (Deauville 1-3)
    • No bone marrow involvement, no new lesions

    Measured: From enrollment to the end of treatment at 12 weeks

  2. Partial Response (PR)

    • Partial Response (PR):
    • ≥30% decrease in the sum of longest diameters of target lesions
    • FDG-PET positive (Deauville 4-5)
    • May still have bone marrow involvement
    • No new lesions

    Measured: From enrollment to the end of treatment at 12 weeks

  3. Minor Response (MR)

    • ≥10% decrease in the sum of longest diameters of target lesions, but not enough to qualify as PR (≥30%)
    • FDG-PET may still show uptake (any finding)
    • Bone marrow involvement may persist
    • No new lesions

    Measured: From enrollment to the end of treatment at 12 weeks

  4. Stable Disease

    • <10% decrease or ≤20% increase in the sum of longest diameters of target lesions
    • FDG-PET findings may remain positive
    • Bone marrow involvement may persist
    • No new lesions

    Measured: From enrollment to the end of treatment at 12 weeks

  5. Progressive Disease

    • >20% increase in the sum of longest diameters of target lesions
    • For small lymph nodes (<15 mm post-therapy), a minimum absolute increase of 5 mm and long diameter >15 mm is required
    • Appearance of new lesions automatically qualifies as PD
    • Any FDG-PET finding consistent with progression
    • Bone marrow involvement may persist or newly appear

    Measured: From enrollment to the end of treatment at 12 weeks

  6. Progression free Survival (PFS)

    the time from randomization (or study entry) until objective disease progression or death from any cause, whichever occurs first as assessed using standardized tumor response criteria (RECIL)

    Measured: From enrollment to up to 2 years post-treatment

  7. Quality of Life (QoL)

    Quality of Life (QoL) defined and measured by EORTC QLQ-C30, a standardized, cancer-specific questionnaire developed by the European Organization for Research and Treatment of Cancer.

    Measured: at the end of treatment at 12 weeks

  8. Adverse Events

    Adverse events graded as per CTCAE version 5.0

    • Haematological: anaemia, neutropenia, and thrombocytopenia
    • Non-haematological: renal dysfunction, hepatotoxicity, mucositis, nausea, and neuropathy

    Measured: From enrollment to the end of treatment at 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Jul 2026
  2. Study start18 Mar 2026
  3. Primary completion20 May 2027 (estimated)
  4. Study completion20 Oct 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
74 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07739654
Sponsor's protocol ID
KEMU-IRB-77-RC-2026
Acronym
MOD-DHAP
Status last verified
Aug 2026
First submitted
28 Jul 2026
Last updated
10 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: IPD will not be shared but could be provided by the principal investigator (PI) up on reasonable request

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Cisplatin (modified schedule), Cisplatin and Dexametasone in people with DLBCL - Diffuse Large B Cell Lymphoma, run by King Edward Medical University at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 10 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Inbsaat Iqbal, MBBS, MD (+923099533745, inbsatiqbal56@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Response rate (ORR) (time frame: From enrollment to the end of treatment at 12 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Aug 2026.

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