Low-dose radiation with standard chemoimmunotherapy, guided by blood tests, for lymphoma
Tests low-dose radiation added to standard treatment in adults with diffuse large B-cell lymphoma.
Key facts
- Who runs it
- University of Nebraska
- Where
- Omaha, United StatesSee the site
- Trial code
- Registry title
- MRD-Adapted Low-Dose Radiation Therapy During Frontline Chemoimmunotherapy for Diffuse Large B-Cell Lymphoma
- Status
- Not yet recruiting
- Phase
- Phase 2
- People taking part
- 50 people, planned
- Starts
- 12 Dec 2026
- Expected to end
- 12 Feb 2033
- Type of study
- Interventional, 2 groupsOne group gets an existing treatment, for comparison.
- Treatments tested
- Low-Dose Radiation Therapy (LDRT)
- Standard Frontline Chemoimmunotherapy
- Record updated
- 6 November 2026
Who can take part
AI summary
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults with newly diagnosed diffuse large B-cell lymphoma (or a related large B-cell lymphoma) who plan to get 6 cycles of R-chemoimmunotherapy as their first treatment.
- Age
- 19 years or older
- Sex
- All sexes can join
- Disease stage
- Newly diagnosed DLBCL, lymphoma transformed from a slow-growing lymphoma, follicular lymphoma grade 3B, post-transplant lymphoproliferative disorder, or another large B-cell lymphoma. Must have a lesion on imaging: a lymph node over 1.5cm (0.6 in) or a lesion outside the nodes over 1 cm (0.4 in), before treatment starts.
- Earlier treatment
- Can have had up to one cycle of R-chemoimmunotherapy before joining. Cannot have had two or more cycles for this disease.
- Biomarker or test result
- Enough tumor tissue from the first biopsy must be available to build a personal MRD test.
Main reasons for not taking part
- Early-stage disease (stage I-II) that needs fewer than 6 cycles of treatment
- Lymphoma in the brain or spinal fluid (CNS lymphoma)
- Too much radiation already received in life, or radiation judged unsafe
- Pregnant or breastfeeding
- Two or more cycles of R-chemoimmunotherapy already given for this disease
The registry criteria, word for word
Show all 10 criteriaShow less
Who can take part
- Adults ≥19 years of age
- Biopsy-proven newly diagnosed DLBCL, transformed from indolent lymphoma, Follicular lymphoma grade 3B, post-transplant lymphoproliferative disorder, or any other subtypes of Large B-cell lymphoma under WHO-HAEM5 classification who are eligible and plan to receive 6 cycles of R-chemoimmunotherapy. Note: patients may receive up to one cycle of R-chemoimmunotherapy prior to enrollment
- Planned to receive 6 cycles of frontline R-chemoimmunotherapy for diseases mentioned in criterion 2
- Presence of measurable disease on imaging, nodal lesion >1.5cm or extra-nodal lesion >1 cm prior to initiation of R-chemoimmunotherapy
- Availability of sufficient and viable baseline FFPE tumor tissue to allow development of a personalized MRD assay
Who cannot take part
- Subject has exceeded maximum lifelong cumulative doses of radiation therapy or is unsafe for radiation therapy as determined by the investigator and/or radiation oncologist
- Has received two or more cycles of R-chemoimmunotherapy relating to this disease
- Limited stage (Ann Arbor stage I-II) DLBCL, requiring less than 6 cycles of R-chemoimmunotherapy
- Primary or secondary CNS lymphoma
- Pregnant and lactating patients
Where in United States
- Fred & Pamela Buffet Cancer CenterOmaha, United StatesContact: Snegha Ananth, MBBSNot yet recruiting
About the trial
What the trial wants to find out
This prospective Phase IIA feasibility study evaluates a minimal residual disease (MRD)-adapted treatment strategy in patients with diffuse large B-cell lymphoma (DLBCL) receiving frontline R-chemoimmunotherapy. Circulating tumor DNA (ctDNA)-based MRD testing and interim positron emission tomography (PET) imaging after two cycles of therapy are used to guide treatment decisions. Patients with detectable MRD and residual PET-avid or measurable disease suitable for radiation therapy receive protocol-directed low-dose radiation therapy (LDRT) in addition to standard systemic therapy. Patients with undetectable MRD, or detectable MRD without targetable residual disease, continue standard frontline chemoimmunotherapy without protocol-directed LDRT.
The 2 groups in the trial
- Arm- A: MRD-Detectable with Protocol-Directed LDRTTreatment being tested
Participants with detectable circulating tumor DNA minimal residual disease (ctDNA MRD) after cycle 2 of frontline R-chemoimmunotherapy and residual PET-avid or measurable disease suitable for radiation therapy receive protocol-directed low-dose radiation therapy (LDRT) to targetable residual disease sites in addition to standard frontline chemoimmunotherapy.
Treatment: Low-Dose Radiation Therapy (LDRT) and Standard Frontline Chemoimmunotherapy
- Arm B: Standard Therapy Without Protocol-Directed LDRTExisting treatment, for comparison
Participants with undetectable circulating tumor DNA minimal residual disease (ctDNA MRD) after cycle 2 of frontline R-chemoimmunotherapy, or participants with detectable MRD but without residual PET-avid or measurable disease suitable for radiation therapy, continue standard frontline chemoimmunotherapy without protocol-directed low-dose radiation therapy (LDRT).
Treatment: Standard Frontline Chemoimmunotherapy
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorData and sources
- Registry record
- Listed on ClinicalTrials.gov.
- Official title
- Feasibility of MRD-Adapted Mid-Cycle Low-Dose Radiation Combined With Frontline R-Chemoimmunotherapy in Diffuse Large B-Cell Lymphoma (MRD XRT)
- Plain-language title
- Low-dose radiation with standard chemoimmunotherapy, guided by blood tests, for lymphomaGenerated from the registry record. The registry title is the official one.
- AI summary
- From the trial's eligibility criteria. Read by machine on 12 November 2026.
- Record updated
- 6 November 2026