eligibility_summary
Adults 18–80 with biopsy‑proven Richter transformation (CLL/SLL→CD20+ DLBCL), prior CLL therapy allowed, none for RS. ECOG 0–2, measurable disease or marrow RS, adequate organ function, HBV/HCV/HIV‑neg, COVID‑vax/PCR−, consent and hospitalization. Exclude: Hodgkin‑variant, CNS, CHOP‑ineligible, prior bispecifics/transplant or high‑dose steroids, active infection/autoimmune, cardiac/lab issues, PML/MAS‑HLH, recent surgery/vaccine/trial, pregnancy/breastfeeding, noncompliance/no social security.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase 2 single-arm frontline study in untreated Richter syndrome (CLL transformed to DLBCL) testing: 1) Glofitamab: humanized bispecific antibody (CD20×CD3, 2:1) that binds CD20 on B cells and CD3 on T cells to redirect T‑cell cytotoxicity, step‑up dosing to limit cytokine release syndrome. 2) Anti‑CD20 mAbs: rituximab (type I, chimeric) and obinutuzumab (type II, glycoengineered) depleting CD20+ B cells via ADCC/CDC and direct cell death, obinutuzumab used early to reduce CRS risk. 3) CHOP: cyclophosphamide (alkylator, DNA crosslinks), doxorubicin (anthracycline, topoisomerase II inhibition/ROS), vincristine (vinca alkaloid, microtubule inhibitor), prednisone (glucocorticoid, lympholytic). Targets/pathways: CD20+ malignant B cells, CD3 on T cells, DNA replication/repair, topoisomerase II, microtubules, and glucocorticoid‑mediated apoptosis.