eligibility_summary
Include: Adults ≥18, untreated, path‑confirmed DLBCL, ECOG 0–2, stage II–IV, NCCN‑IPI ≥2, measurable FDG‑avid disease, LVEF ≥45%, life ≥3 mo, contraception, labs OK (CrCl ≥30, bili ≤1.5×ULN, AST/ALT ≤3×ULN, Plt ≥50k, ANC ≥1000, Hb ≥8). Exclude: double/triple‑hit, other active cancers, CNS involvement, other trials, recent therapy/transplant/surgery, uncontrolled infection/depression, significant comorbidity/QTc, ↑troponin/BNP/amylase, active HBV/HCV/HIV (per limits), pregnancy, prohibited CYP drugs/NNRTIs.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Trial in high‑risk diffuse large B‑cell lymphoma tests adding roflumilast (Daliresp), an oral phosphodiesterase‑4 (PDE4) inhibitor, to standard R‑CHOP. Interventions and mechanisms: • Roflumilast (small‑molecule PDE4 inhibitor): raises intracellular cAMP in leukocytes, reducing pro‑inflammatory cytokines and myeloid/T‑cell immunosuppression, potentially enhancing anti‑tumor immunity. • Rituximab (anti‑CD20 monoclonal antibody): depletes malignant B cells via ADCC, CDC, and apoptosis. • Cyclophosphamide (alkylating agent): DNA crosslinking → apoptosis. • Doxorubicin (anthracycline): DNA intercalation, topoisomerase II inhibition, ROS generation. • Vincristine (vinca alkaloid): microtubule inhibition → mitotic arrest. • Prednisone (glucocorticoid): lympholytic, pro‑apoptotic, anti‑inflammatory. Targets/pathways: CD20+ malignant B cells, DNA damage/repair and mitotic machinery, Fc/complement effector pathways, PDE4–cAMP signaling in immune cells and tumor microenvironment.