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Supporting people with non-Hodgkin's lymphoma
Experimental treatments

Keypoints

  • Clinical trials for non-Hodgkin's lymphoma may be an opportunity to test new drugs that are potentially better than current treatments
  • In most cases, not all patients taking part in the trial will be given the drug being tested, but will get a currently used drug instead
  • All clinical trials meet strict criteria and must be approved, and patients do not have to take part - they will still get current treatments

Because not all treatments work in all patients with non-Hodgkin's lymphoma, the search is always on for new, better treatments and for better ways of combining existing treatments. A treatment may prove to be better because it has more effect against the lymphoma or because it causes fewer or less dangerous side effects - or a combination of both.

Part of this ongoing search for better treatments involves clinical trials. If early research and experiments have suggested that a new treatment may be better than the current standard treatment, then a trial is conducted for the new treatment to be compared with the current treatment. The comparison with an existing treatment, whose effectiveness is already known, acts as a 'control' - hence the trial is a 'controlled trial'.

Usually, about half the patients in a controlled trial receive the standard treatment and about half receive the new treatment. So that the comparison can be truly objective, the decision over which treatment each individual patient in the trial is given is taken at random, usually by computer, and not by the doctor who is treating the patient or by the doctors who are running the trial. Hence the trial is a 'randomised trial'

Therefore, these clinical trials are often referred to as 'randomised controlled trials'. Such trials are the only way that new treatments for a condition such as non-Hodgkin's lymphoma can be scientifically verified as being effective and worthwhile treatments. Clinical trials are therefore very important for improving management of the condition, both for patients today and in the future.

All clinical trials will have been examined and approved by an ethics committee and will have met rigorous governmental and medical criteria. The new treatment that is being assessed will have been the subject of very careful research before it reaches the clinical trial stage. Because the trial is randomised, however, there can be no guarantee that any particular patient will receive the new treatment..

Any patient who takes part in a clinical trial must give informed consent. No one can be forced to take part in a trial or be put under pressure to do so. And, once in a trial, a patient can leave the trial at any time, without having to give any reason for this decision. A patient who chooses not to take part in a trial, or who leaves a trial, will still receive the best current standard treatment - it will not have any affect on the attitude of the doctor and other health professionals to the patient.

For patients who would like to find out more about clinical trials, local lymphoma support groups can often provide information on clinical trials in your country. For more information, see Finding support.

The table describes the types of clinical trial that can be performed to help in the search for new treatments

Phase I
Small number of patients are given a new treatment to test safety and appropriate dose. Increased risk of side effects means patients often have advanced disease that will not respond to current treatments
Phase II
Larger number of patients than Phase I; focus not only on side effects of a new treatment but also on disease response

Phase III

Once a Phase II trial has shown that a new treatment is effective against a disease, large numbers of patients are recruited to compare it with standard treatments or an inactive placebo. Clinical trials in cancer, however, do not use a placebo due to ethical considerations
Phase IV
After a treatment is licensed for use in patients, a phase IV trial, is carried out to further optimise the treatment or to test the use of the treatment in additional indications

 

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