MRD-Adapted Low-Dose Radiation Therapy During Frontline Chemoimmunotherapy for Diffuse Large B-Cell Lymphoma

Starting soon · Phase 2

Conditions studied: Diffuse Large B-Cell Lymphoma

In brief

This prospective feasibility study evaluates a minimal residual disease (MRD)-adapted treatment strategy in patients with diffuse large B-cell lymphoma (DLBCL) receiving frontline chemoimmunotherapy. Circulating tumor DNA (ctDNA)-based MRD testing and interim positron emission tomography (PET) imaging after two cycles of therapy are used to guide treatment decisions. Patients with detectable MRD may receive low-dose radiation therapy (LDRT) to residual PET-avid disease sites in addition to standard systemic therapy, while patients with undetectable MRD continue standard frontline chemoimmunotherapy. The study aims to assess the feasibility and safety of integrating MRD-guided radiation therapy into frontline treatment of DLBCL.

Key facts

Study ID

NCT07517705

Run by

University of Nebraska

People needed

50

Starts

2026-06-12

Expected to finish

2032-11-12

Last updated by the study team

2026-05-13

Who can join

Age: 19 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Adults ≥19 years of age
• Biopsy-proven newly diagnosed DLBCL, transformed from indolent lymphoma, Follicular lymphoma grade 3B, post-transplant lymphoproliferative disorder, or any other subtypes of Large B-cell lymphoma under WHO-HAEM5 classification who are eligible and plan to receive 6 cycles of R-chemoimmunotherapy. Note: patients may receive up to one cycle of R-chemoimmunotherapy prior to enrollment.
• Planned to receive 6 cycles of frontline R-chemoimmunotherapy for diseases mentioned in criterion 2
• Presence of measurable disease on imaging, nodal lesion >1.5cm or extra-nodal lesion >1 cm prior to initiation of R-chemoimmunotherapy
• Availability of sufficient and viable baseline FFPE tumor tissue to allow development of a personalized MRD assay

You may not qualify if…

• Limited stage (Ann Arbor stage I-II) DLBCL, requiring less than 6 cycles of R-chemoimmunotherapy
• Primary or secondary CNS lymphoma
• Subject has exceeded maximum lifelong cumulative doses of radiation therapy or is unsafe for radiation therapy as determined by the investigator and/or radiation oncologist
• Pregnant and lactating patients
• Has received two or more cycles of R-chemoimmunotherapy relating to this disease

Where it is running

• Fred & Pamela Buffet Cancer Center — Omaha, Nebraska, United States

Full record on ClinicalTrials.gov

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