eligibility_summary
Eligible: adults (≥18) with untreated CD20+ FL grade 1–3a, FLIPI 2–5, any stage (I if FLIPI≥2), need treatment (bulky disease, B symptoms, cytopenias, compression, effusions, ↑LDH/β2M), FDG‑avid measurable lesion, ECOG≤2, adequate organ function, contraception. Exclude: grade 3b/transformed FL, prior RT/lymphoma, recent therapy/immunosuppression/live vaccines, active HBV/HCV/COVID, major autoimmune/CNS/cardiopulm disease, transplant, ILD/pneumonitis, PML/HLH, other active cancer, pregnancy/lactation.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase III, randomized trial in untreated FLIPI 2–5 follicular lymphoma. Experimental: mosunetuzumab + lenalidomide. Mosunetuzumab: bispecific CD20×CD3 IgG that redirects/activates T cells via CD3 to kill CD20+ B cells (T-cell cytotoxic synapse, cytokine-mediated killing). Lenalidomide: immunomodulatory (IMiD) binding cereblon to degrade IKZF1/3, enhancing T- and NK-cell activation, anti-angiogenesis, and direct antitumor effects. Control options: anti-CD20 mAb + chemotherapy—rituximab (type I anti-CD20 IgG1) or obinutuzumab (glycoengineered type II anti-CD20) depleting B cells via ADCC/ADCP, CDC (notably with rituximab), and direct apoptosis, plus CHOP (cyclophosphamide—alkylator, doxorubicin—topo II inhibitor, vincristine—microtubule inhibitor, prednisone—lympholytic) or bendamustine (alkylator). Targets/pathways: CD20+ malignant B cells, CD3 T-cell activation, cereblon–IKZF axis, Fc-mediated cytotoxicity/complement, DNA damage/apoptosis.