Study summary

A chemotherapy-free pill-and-antibody combination beat chemotherapy for older adults

ENRICH trial · 397 people, phase 3 · Published October 2025, The Lancet

What was tested

Ibrutinib plus rituximab, against rituximab-based chemo-immunotherapy (R-CHOP or bendamustine-rituximab), for untreated mantle cell lymphoma in people 60 and older.

What they found

• Risk of progression or death was 31% lower with ibrutinib-rituximab (hazard ratio 0.69).
• The benefit was largest against R-CHOP (hazard ratio 0.37).
• Serious side effects were similar (67% vs 70%).

What it means

The first randomized trial to show a chemotherapy-free first treatment beats chemotherapy in this disease.