eligibility_summary
Adults 18–75 with WHO 2016–confirmed primary CNS DLBCL, ECOG 0–1, survival >3 mo, adequate organ function, contraception/negative pregnancy test, consent/compliance. Exclude: drug allergy, recent investigational therapy/radiation/surgery/serious infection, recent stroke/ICH or ≥G3 GI bleed, pregnancy/breastfeeding, significant heart disease, HIV/immunodeficiency/TB, uncontrolled HTN/DM, active HBV/HCV, other malignancy, psychiatric/substance issues, or if deemed unsuitable.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Intervention: ZRMT (zanubrutinib–rituximab–methotrexate–temozolomide) induction ± ASCT, then zanubrutinib maintenance. Drug types and mechanisms: Zanubrutinib—oral covalent small‑molecule BTK inhibitor, blocks B‑cell receptor (BCR) signaling and downstream NF‑κB survival pathways, particularly relevant to MYD88/CD79B‑mutated (MCD/ABC) PCNSL. Rituximab—anti‑CD20 monoclonal antibody, depletes malignant B cells via CDC/ADCC and apoptosis. High‑dose methotrexate—antimetabolite antifolate (DHFR inhibitor), inhibits thymidylate/purine synthesis, S‑phase cytotoxic, CNS‑penetrant. Temozolomide—oral alkylating (DNA‑methylating) agent, induces DNA damage (O6/N7 guanine) and apoptosis, crosses BBB. Cells/pathways targeted: CD20+ malignant B cells in PCNSL, BCR/BTK→NF‑κB signaling, DNA synthesis and repair pathways in tumor cells.