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.
Plain-language title generated from the registry record
Registry title: MRD-Adapted Low-Dose Radiation Therapy During Frontline Chemoimmunotherapy for Diffuse Large B-Cell Lymphoma
Key facts
- Where
- Omaha, United StatesSee the site
- Phase
- Phase 2
Where in United States
- Fred & Pamela Buffet Cancer CenterOmaha, United StatesNo longer taking part
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?
Trial details
- Who runs it
- University of Nebraska
- Trial code
- NCT07517705
- Record updated
- 6 November 2026
- Original description
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.Read full original descriptionShow less
Feasibility of MRD-Adapted Mid-Cycle Low-Dose Radiation Combined With Frontline R-Chemoimmunotherapy in Diffuse Large B-Cell Lymphoma (MRD XRT)
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.
Inclusion: 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.
Exclusion: 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.