eligibility_summary
Eligible: adults 18–75, previously untreated CD20+ DLBCL, IPI 2–5, ECOG 0–2, life expectancy ≥6 months. Exclude: contraindications to study drugs, prior systemic/local therapy or ASCT, other active malignancy, uncontrolled cardio/cerebrovascular, coagulopathy, connective tissue or severe infection, PCNSL, LVEF ≤50%, abnormal labs (ANC<1.0, PLT<75, Hb<100, AST/ALT≥2.5×ULN, bili≥1.5×ULN, creat≥1.5×ULN), psychiatric noncompliance, pregnancy/lactation, active HBV/HIV.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Intervention: All receive R-CHOP, then ctDNA at C1D14 guides therapy. R-CHOP drugs and mechanisms: rituximab (anti-CD20 monoclonal antibody causing B-cell depletion via ADCC/complement/apoptosis), cyclophosphamide (alkylating chemotherapy), doxorubicin (anthracycline/topoisomerase II inhibitor), vincristine (vinca alkaloid microtubule inhibitor), prednisone (glucocorticoid, lympholytic). If ctDNA suggests resistance, cycles 2–6 add genotype-guided targeted agents: obutinib (BTK inhibitor, small-molecule TKI of BCR signaling), decitabine (DNMT-inhibiting hypomethylating nucleoside analog), lenalidomide (IMiD, cereblon-mediated, boosts T/NK cells, down-modulates NF-κB), or chidamide (HDAC inhibitor). Cells/pathways: CD20+ malignant B cells, BCR/BTK signaling, epigenetic dysregulation (DNA methylation, histone deacetylation), microtubules, DNA damage/topo II, glucocorticoid pathways, ADCC/complement.