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临床试验/NCT06736613
NCT06736613招募中2 期

Cerebral Spinal Fluid Circulating Tumor DNA (ctDNA) Analysis in Patients With Aggressive B-cell Lymphoma Receiving Front Line Therapy and at High Risk for Central Nervous System Relapse

Memorial Sloan Kettering Cancer Center14 个研究点 分布在 1 个国家目标入组 50 人开始时间: 2024年12月11日最近更新:
适应症

试验速览

阶段
2 期
状态
招募中
入组人数
50
试验地点
14
主要终点
Incidence of positive cerebral spinal fluid/CSF ctDNA

研究概览

简要总结

The purpose of this study is to find out how many people with B-cell lymphoma who are at high risk for central nervous system/CNS relapse test positive for cerebral spinal fluid/CSF ctDNA but test negative for CNS involvement using standard tests. The study will also look at how often CNS relapse happens in people with and without detected CSF ctDNA.

研究设计

研究类型
Interventional
分配方式
Na
干预模型
Single Group
主要目的
Diagnostic
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Signed Informed Consent.
  • Ability and willingness to comply with the requirements of the study protocol.
  • Age ≥ 18 years old.
  • Diagnosis of the following histologies according to the 2016 WHO Classification for Mature Lymphoid Neoplasms81 along with a specific high-risk criteria for CNS relapse if indicated as certain diagnoses in of themselves are high-risk alone:
  • Diffuse Large B-cell Lymphoma (DLBCL) with CNS IPI score ≥
  • Stage III/IV High Grade B-cell lymphoma (HGBCL) with MYC, BCL2, and/or BCL6 translocations
  • Primary DLBCL of Breast
  • Primary DLBCL of Testis
  • Primary Cutaneous DLBCL, Leg Type
  • Intravascular Large B-cell Lymphoma
  • Stage III/IV HIV-associated DLBCL
  • Double expressor DLBCL (co-expression of MYC ≥ 40% and BCL2 ≥ 50% without translocations) with a CNS IPI score ≥ 3
  • DLBCL with the following extranodal involvement AND CNS IPI score ≥ 3:
  • i. Adrenal ii. Breast iii. Bone Marrow with pathological overt morphological involvement iv. Epidural/Paraspinal v. Nasal/parasinus with local invasion such as bone destruction vi. Renal viii. Uterine ix. Testis xi. Skull involvement without direct invasion into CNS/brain parenchyma
  • Transformed DLBCL from any indolent B-cell lymphoma is permitted (as long as there is no prior history of CNS involvement).
  • Planned to receive standard chemoimmunotherapy.
  • Patient is able to undergo lumbar puncture without any contraindications which include but are not limited to altered mental status, increased intracranial pressure due to any CNS lesion (mass, abscess), overlying skin infection at the site of LP, inability to safely access CSF due to lymphomatous involvement (i.e. epidural mass), or inability to hold antiplatelet or anticoagulation safely for the procedure to be performed.
  • No systemic therapy prior to study enrollment for an aggressive B-cell lymphoma is permitted. Treatment for a history of indolent lymphoma is permitted. Systemic corticosteroids are permitted (must be ≤7 days and tapered down to prednisone ≤ 20 mg oral/day or steroid equivalent by first day of anthracycline treatment). Clinical exceptions in regards to steroid management can be made after discussion with PI.
  • ECOG performance status of 0 to 2.

排除标准

  • Active systemic therapy for another malignancy (other than indolent B-cell lymphoma) within 2 years; local/regional therapy with curative intent such as surgical resection or localized radiation within 2 years of treatment is permitted.
  • Active concurrent malignancy with the exception of basal cell or localized squamous cell skin carcinoma, localized prostate cancer, or other localized carcinomas such as carcinoma in situ of cervix, breast, or bladder.
  • Any uncontrolled illness that in the opinion of the investigator would preclude administration of curative intent chemoimmunotherapy (e.g. significant active infections, hypertension, angina, arrhythmias, pulmonary disease, or autoimmune dysfunction).
  • Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection (excluding fungal infections of nail beds) at study enrollment, or any major episode of infection requiring treatment with IV antibiotics or hospitalization within 2 weeks prior to Cycle 1, Day
  • Psychiatric illness or social situations that would limit the patient's ability to tolerate and/or comply with study requirements.

结局指标

主要结局

Incidence of positive cerebral spinal fluid/CSF ctDNA

时间窗: up to 2 years

The primary objective is to describe the incidence of positive CSF ctDNA in participants at high-risk for CNS relapse

次要结局

未报告次要终点

研究者

申办方类型
Other
责任方
Sponsor

研究点 (14)

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