Internationally recognised, Plymouth led cancer trial changes treatment landscape for lymphoma patients
University Hospitals Plymouth Consultant Haematologist, Dr David Lewis has received an award at the European Haematology Association Congress, held in Stockholm for Best European Research. It celebrates more than a decade of work on the ENRICH study, that is transforming care for patients with mantle cell lymphoma.
The trial, which has been running for 12 years, is led by Dr Lewis and managed by Peninsula Clinical Trial Unit (PenCTU) at the University of Plymouth. The study was supported by Cancer Research UK and Janssen. The landmark study, published in The Lancet, demonstrated that a targeted, chemotherapy-free treatment approach can deliver better outcomes for older patients with mantle cell lymphoma (MCL), a rare and aggressive form of non-Hodgkin lymphoma.
The phase 2/3 trial explored whether a combination of ibrutinib, a cancer growth-blocking tablet, and rituximab, an antibody therapy, could improve outcomes compared with standard chemotherapy treatments. For many older patients, intensive chemotherapy is not suitable due to its significant side effects, creating an urgent need for more effective and better tolerated alternatives.
The study recruited 400 patients aged 60 and over, from centres across the UK, Sweden, Norway, Denmark and Finland. Participants were randomly assigned to receive either standard chemotherapy plus rituximab or the targeted combination of ibrutinib and rituximab. Researchers also incorporated quality-of-life assessments and minimal residual disease monitoring to better understand treatment responses and future patient needs.
Results show that the combination of ibrutinib and rituximab is superior to standard chemotherapy treatment, with particularly strong benefits seen compared with R-CHOP chemotherapy. The targeted treatment was also shown to perform at least as well as R-bendamustine chemotherapy, offering patients a highly effective alternative without the burden of traditional chemotherapy.
Beyond the clinical findings, the impact on patients has been significant. Since the study began, ibrutinib has changed lives, offering many people the opportunity to manage their disease with a tablet-based treatment rather than undergoing intensive chemotherapy. Dr David Lewis said: “This is a tremendous achievement and represents a significant milestone in the treatment of lymphoma. This is the first study ever reported which shows an improved result with a non-chemotherapy-based treatment compared with standard chemotherapy in the treatment of non-Hodgkin lymphoma. It gives patients hope that one day they may not need to undergo chemotherapy for the treatment of their cancer and could take a tablet instead.”
The recognition at the European Haematology Association Congress highlights the international significance of the ENRICH trial and the dedication of the clinicians, PenCTU, researchers and patients who have contributed to the study over the past 12 years.
In 2025, the PenCTU ENRICH team was awarded the University’s prestigious Vice-Chancellor’s award for ‘making a difference through research and impact’. Professor Allgar, Director of PenCTU, said “ENRICH shows how a Plymouth‑led trial can shape cancer care internationally. PenCTU is proud to have delivered a study in partnership with University Hospitals Plymouth that offers patients a real alternative to chemotherapy and sets a new benchmark for global trial innovation.”
The success of ENRICH underscores the strength of the partnership between University Hospitals Plymouth and the University of Plymouth, demonstrating the power of collaboration between clinicians and researchers to bring innovative treatments to patients and expand treatment options for older people living with mantle cell lymphoma.
