eligibility_summary
Eligible: adults (≥18) with biopsy‑confirmed relapsed/refractory CD20+ follicular lymphoma grade 1–3a (recent biopsy), needing treatment, PET‑CT measurable, ECOG 0–2, adequate marrow, liver, kidney, coagulation, and LVEF, prior ≥1 immunochemotherapy, consent/contraception. Exclude: recent high‑grade transformation or non‑FDG‑avid disease, prior allo‑transplant, lenalidomide, CAR‑T ≤100d, early planned SCT/maintenance, HIV/uncontrolled HCV/active HBV, other cancers <2y, active infection/CNS disease, anti‑CD20 allergy, serious comorbidity, recent therapy/steroids/surgery, pregnancy, severe cardiac disease.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
REFRACT (NCT05848765) is a phase II platform in relapsed/refractory CD20+ follicular lymphoma. Round 1 tests epcoritamab + lenalidomide vs investigator-choice standard regimens (R-CHOP, R-CVP, bendamustine–rituximab, rituximab–lenalidomide, or obinutuzumab–bendamustine). Mechanisms: Epcoritamab is a bispecific T‑cell–engaging antibody (CD20×CD3) that redirects cytotoxic T cells to kill malignant B cells. Lenalidomide is an IMiD that binds cereblon, degrades IKZF1/3, and enhances T‑ and NK‑cell activation, augmenting anti‑CD20 immunity. Comparator drugs: Rituximab/obinutuzumab (anti‑CD20 mAbs, B‑cell depletion via ADCC/CDC/direct death), bendamustine/cyclophosphamide (alkylators, DNA crosslinks), doxorubicin (anthracycline, topo II inhibition/free radicals), vincristine (vinca, microtubule inhibitor), prednisone (corticosteroid, lymphocyte apoptosis). Targets/pathways: CD20+ B cells, CD3 T‑cell activation, ADCC/CDC, cereblon/IKZF, DNA damage, microtubules, topoisomerase II, glucocorticoid receptor.