eligibility_summary
Adults 18–80 with untreated DLBCL and CSF‑ctDNA–positive secondary CNS lymphoma, CNS lesion on MRI/CT (meningeal disease requires CSF cytology), ECOG 0–3, adequate marrow, liver, renal (CrCl ≥40), life expectancy >3 mo, no chemo/RT/antibody ≤3 wks or targeted ≤10 d, contraception, consent. Exclude prior BTKi, unresolved toxicity, cardiac disease or QTcF>450, active bleeding/infection (HBV/HCV/HIV), effusions, surgery <4 wks, strong CYP3A drugs, pregnancy, psych/substance abuse, investigator judgment.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase 2, molecular subtype–guided therapy for newly diagnosed DLBCL with CNS involvement. MCD/BN2/N1: R-CHOP + high-dose methotrexate (MTX) + zanubrutinib, EZB/A53/other: R-CHOP + MTX. CSF-ctDNA guides continuation (rituximab alone or with temozolomide/lenalidomide/pomalidomide) until clearance. Drug types/mechanisms: rituximab (anti-CD20 mAb, B-cell depletion), cyclophosphamide (alkylating agent), doxorubicin (anthracycline/topoisomerase II inhibitor), vincristine (vinca alkaloid, microtubule inhibitor), prednisone (glucocorticoid, lymphocyte apoptosis), MTX (antifolate DHFR inhibitor, CNS-penetrant), zanubrutinib (covalent BTK inhibitor, blocks BCR signaling), temozolomide (DNA-methylating alkylator), lenalidomide/pomalidomide (IMiDs, cereblon-mediated IKZF1/3 degradation, immune modulation). Targets/pathways: CD20+ malignant B cells, BCR/BTK→NF-κB (esp. MCD/BN2/N1), folate metabolism/DHFR, DNA replication/repair, microtubules, topo II, glucocorticoid signaling.