Clinical Trial Trends: Non-Hodgkin’s Lymphoma

Non-Hodgkin’s Lymphoma (NHL) is a diverse group of blood cancers that originate in the lymphatic system

NHL makes up almost 3 percent of cancer diagnoses worldwide. In the United States alone, there are more than 77,000 cases diagnosed each year, making it the seventh most common cancer in the country. There are many types of NHL which are broadly categorized into B-cell and T-cell lymphomas. B-cell lymphoma is most prevalent (85%) and includes types such as diffuse large b-cell lymphoma (DLBCL) and follicular lymphoma, mantle cell lymphoma. T-cell lymphomas (15%) include peripheral t-cell lymphoma (PTCL) and cutaneous t-cell lymphoma (CTCL). 

Diagnostics are improving for how the disease is detected (e.g., genomic profiling) and choosing the right treatment option for each patient’s specific type of Non-Hodgkin’s Lymphoma. Clinical trials are the forerunner of these improvements.  

The survival rate is fairly high (the NHL five-year overall survival rate is 74% for all types) although this varies widely based on subtype, stage and response to treatments. With the evolution of diagnostics and more recent advances in available treatments, this rate is only expected to improve. In this article, we will take a closer look at trends in NHL research and outline how Precision has helped along the way. 

Non-Hodgkin’s Lymphoma Clinical Trials by Status 

According to Citeline as of September 12, 2024, there have been 9,566 trials targeting NHL patients with approximately 28% of them currently ongoing or planned. 

Non-Hodgkin’s Lymphoma Trials by Status  

Citeline Trialtrove^® – 12SEP2024 

Non-Hodgkin’s Lymphoma Trials by Start Date 

Over recent years, we have seen a significant rise in clinical trial activity in Non-Hodgkin’s Lymphoma as evidenced by the rapid increase in new studies launched annually. The data below provides a visualization of the planned and ongoing NHL trials by start date. 

Planned & Ongoing Non-Hodgkin’s Lymphoma Trials by Start Date  

Citeline Trialtrove^® – 12SEP2024 

Non-Hodgkin’s Lymphoma clinical trials by country 

China, followed closely by the United States, leads the field in quantity of NHL trials. Of the 2,675 ongoing trials, China participates in 46.6% and the US in 34.1%. From the table below, we can see that sites are spread around the world. 

Planned & Ongoing NHL Trials by Site Country – Top 20 

Citeline Trialtrove^® – 12SEP2024 

Non-Hodgkin’s Lymphoma clinical trials by phase 

Analyzing Non-Hodgkin’s Lymphoma clinical trials by phase helps illustrate the progression of research in this indication. The vast majority of NHL trials are concentrated in phases 1 through 2, signifying a strong development pipeline with promising future treatment options.  

Planned & Ongoing Non-Hodgkin’s Lymphoma Trials by Phase  

Citeline Trialtrove^® – 12SEP2024 

Precision’s work in Non-Hodgkin’s Lymphoma research

At Precision for Medicine, we are committed to establishing a foundation for every trial that streamlines research. In the case of Non-Hodgkin’s Lymphoma, this includes navigating the heterogeneity of the disease, developing trial designs that adapt, and having the ability to identify and retain participants that meet the strict inclusion/exclusion criteria typical of this indication.

Precision for Medicine's NHL trials by start date

Precision’s work in Non-Hodgkin’s Lymphoma spans decades. We have initiated 14 new trials in this indication since 2020, and we are dedicated to continuing that work.

Precision for Medicine's Non-Hodgkin’s Lymphoma Trials by start date

Citeline Trialtrove^® – 12SEP2024 

Precision's NHL clinical trials by country

When it comes to Precision’s reach, our work is truly global, and Non-Hodgkin’s Lymphoma is no exception. We have run sites in 44 countries and 6 regions—and counting.

Precision Non-Hodgkin’s Lymphoma Trials by site country

Citeline Trialtrove® – 12SEP2024

Precision for Medicine's NHL clinical trials by phase

The majority of Precision’s work in Non-Hodgkin’s Lymphoma has been in the early phase setting. We have been honored to have a role in these fundamental trials that laid the groundwork for larger scale studies, and we have supported several of those later phase NHL trials.

Precision for Medicine's Non-Hodgkin’s Lymphoma Trials by phase

Citeline Trialtrove® – 12SEP2024

Precision for Medicine's Non-Hodgkin’s Lymphoma clinical trials by patient segment

Our experience encompasses a variety of sub-types of Non-Hodgkin’s Lymphoma, both aggressive and indolent, including diffuse large b-cell, follicular, mantle cell, cutaneous t-cell, Waldenstrom's macroglobulinemia, peripheral t-cell, extranodal marginal zone b-cell, and many others. Our engagement covers all lines of therapy for NHL patients as outlined below.

Notable Precision Non-Hodgkin’s Lymphoma Trials

While much of Precision’s experience in Non-Hodgkin’s Lymphoma has been in earlier phases, we have helped guide one drug development program from Phase 1 through to approval and retargeting. We have also worked on larger NHL clinical trials and have a strong understanding of the challenges inherent in studying this indication.

The Precision difference in NHL research

Non-Hodgkin’s Lymphoma may be a fairly common cancer diagnosis, but studying it is anything but.

• Heterogeneity of NHL Subtypes: The diverse nature of Non-Hodgkin’s Lymphoma subtypes presents significant hurdles in clinical research. Each subtype may require distinct treatment approaches, complicated trial design and patient recruitment. This diversity also impacts result interpretation, as findings from one subtype may not apply universally.
• Patient Enrollment Difficulties: Recruiting eligible participants for NHL trials necessitates multi-center, often international, collaborations due to the rarity of certain subtypes. This leads to logistical challenges in standardizing procedures and ensuring consistent data collection across various sites.
• Long-term Study Requirements: NHL studies frequently require extended observation periods to assess progression free and overall survival. Maintaining patient engagement and minimizing dropout rates over years presents ongoing challenges for researchers and clinicians.
• Personalized Medicine Complexities: Advancements in personalized treatments, such as CAR T-cell therapy, introduce new complexities to the clinical trial process. These therapies require specialized facilities and staff, limiting the number of capable trial sites. Traditional trial designs may not adequately address the individualized nature of these treatments, necessitating innovative approaches to study design and data analysis.
• Evolving Regulatory Landscape: As novel treatment classes emerge, navigating the regulatory environment becomes increasingly complex. Ensuring compliance with varying requirements across different regions adds another layer of difficulty to NHL research efforts
  
  

Choosing the right CRO for your next Non-Hodgkin’s Lymphoma Clinical Trial

As the landscape of NHL research continues to evolve, the expertise of experienced CROs becomes increasingly valuable. The complexities of modern Non-Hodgkin’s Lymphoma trials require a nuanced understanding of the disease, emerging treatment modalities, and the regulatory environment.

CROs with a track record in oncology trials, particularly in hematological malignancies, like Precision for Medicine, are well-positioned to navigate the challenges of NHL research. We can provide crucial insights into trial design, patient recruitment strategies, and regulatory compliance. Our experience can be instrumental in implementing adaptive trial designs, managing the logistical challenges of multi-center studies, and ensuring data integrity across long-term follow-ups.

With our established networks of research sites and investigators, Precision can facilitate access to the specialized facilities and expertise required for cutting-edge NHL treatments. This can be particularly valuable for studies involving complex therapies like CAR T-cells or novel immunotherapies.

Let our team of experts help refine and streamline your next Non-Hodgkin’s Lymphoma and see the difference Precision makes.