eligibility_summary
Eligible: adults with untreated primary B‑cell PCNSL (biopsy/CSF/vitrectomy confirmed), ≥1 measurable lesion, age 18–69 with ECOG ≥2 or ≥70, ineligible for HCT‑ASCT, adequate renal/hepatic/marrow/cardiac/pulmonary function, consent and contraception. Exclude: prior PCNSL tx (except steroid±single rituximab+MTX), systemic lymphoma, prior NHL, isolated ocular/leptomeningeal, HIV, HBV/HCV/HEV, severe infection, immunodeficiency/transplant, hypersensitivity, GI ulcers, pregnancy/lactation, other active cancers, noncompliance/dependence.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
NCT05583071 tests a 4-drug regimen in untreated primary CNS lymphoma (PCNSL) patients ineligible for HCT-ASCT: 1) Methotrexate (antimetabolite, antifolate, IV). Mechanism: inhibits dihydrofolate reductase (DHFR) → blocks thymidylate/purine synthesis and DNA replication in rapidly dividing lymphoma cells. 2) Tafasitamab/Minjuvi (humanized, Fc‑engineered anti‑CD19 IgG1 mAb, IV). Mechanism: binds CD19 on B cells, enhances ADCC/ADCP, induces apoptosis. 3) Rituximab (chimeric anti‑CD20 IgG1 mAb, IV). Mechanism: B‑cell depletion via CDC, ADCC, apoptosis. 4) Lenalidomide/Revlimid (oral immunomodulatory drug). Mechanism: binds cereblon E3 ligase → degrades IKZF1/3, enhances T/NK cell function, augments mAb-mediated ADCC, anti‑angiogenic and direct tumor effects. Targets: CD19+ and CD20+ malignant B cells in CNS, DHFR/folate pathway, cereblon–IKZF1/3 axis, Fcγ receptor–mediated cytotoxicity, complement pathways.