ClinicalTrials.gg
Not yet recruitingNCT07917624Updated Nov 4, 2026

Prophylactic Strategies for Mitigating Central Nervous System Relapse in Diffuse Large B-Cell Lymphoma

A Phase 2 interventional study of Lenalidomide and Bruton's tyrosine kinase inhibitor in Diffuse Large B-Cell Lymphoma (DLBCL), sponsored by Cancer Institute and Hospital, Chinese Academy of Medical Sciences. Not yet recruiting at 1 site in China. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-11-04.

Sponsored by Cancer Institute and Hospital, Chinese Academy of Medical Sciences · Phase 2, Interventional, and Prevention

Updated Nov 4, 2026Newly registeredGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
87
Allocation
Non-randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

Background: The central nervous system (CNS) recurrence rate of patients with high-risk diffuse large B-cell lymphoma (DLBCL) is as high as 15% - 20%, and the prognosis is extremely poor once it occurs. Current intrathecal injection and high-dose methotrexate prophylaxis are ineffective and have significant toxicity. Lenalidomide, BTK inhibitors, and sidaribine all can penetrate the blood-brain barrier, and each has shown a signal of reducing the risk of CNS recurrence in previous studies, but there is still a lack of prospective concurrent comparative data.

Objective: To preliminarily evaluate the efficacy and safety of using these three oral drugs (lenalidomide, BTK inhibitors, and sidaribine) in combination with first-line immunotherapy chemotherapy for high-risk DLBCL patients to prevent CNS recurrence during the same period or after chemotherapy.

Method: This study is a phase II exploratory, open-label, non-randomized concurrent multi-cohort study, combined with historical external controls. A total of 87 patients with DLBCL diagnosed by histopathology and having at least one CNS high-risk factor (CNS-IPI ≥ 4 points, specific extranodal involvement (such as testis, breast, adrenal gland, kidney, uterus, bone marrow, bone), and extranodal invasion sites ≥ 2) are planned to be enrolled. Patients can choose to enter the lenalidomide group, BTK inhibitor group (ibrutinib, zanubrutinib, or obinutinib) or sidaribine group based on their disease characteristics and economic conditions, and the preventive treatment lasts for 1 year. The primary endpoint is the 2-year cumulative CNS recurrence rate (competitive risk model analysis), and the secondary endpoints include progression-free survival time, overall survival time, CNS disease-free survival time, and safety.

Significance: This study is the first to prospectively compare the CNS preventive value of these three drugs with different mechanisms in high-risk DLBCL patients, which is expected to provide key exploratory data for this field and lay the foundation for future confirmatory studies.

02

Conditions studied

  • Diffuse Large B-Cell Lymphoma (DLBCL)
03

In context

Lymphoma, Large B-Cell, Diffuse

1,868 studies on the registry are indexed under Lymphoma, Large B-Cell, Diffuse; 355 are open to participants now.

This study's planned enrollment of 87 is above the median of 45 across 1,497 interventional studies indexed under Lymphoma, Large B-Cell, Diffuse.

Browse Lymphoma, Large B-Cell, Diffuse studies →

Lead sponsor

Cancer Institute and Hospital, Chinese Academy of Medical Sciences is the lead sponsor of 393 studies on the registry; 280 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • 1. The diagnosis of diffuse large B-cell lymphoma, non-specific type or indolent lymphoma that has undergone large B-cell transformation, has been confirmed by histopathological examination; according to the 2016/2022 WHO classification, advanced B-cell lymphoma with dual expression/dual therapy is allowed; 2. Age between 18 and 80 years; 3. Proposed or currently receiving standard immunotherapy, and planning to complete at least 6 cycles; 4. Baseline examination including brain-enhanced MR and cerebrospinal fluid cytology/flow cytometry by lumbar puncture was conducted to rule out CNS invasion; 5. Has at least one high-risk factor for CNS recurrence: CNS-IPI score ≥ 4 points; or involving specific extranodal sites (such as testis, breast, adrenal gland, kidney, uterus, bone marrow, high-risk bones); or extranodal invasion sites ≥ 2; 6. physical status score 0-2; 7. The subject can understand the study protocol and is willing to participate in this study, and signs a written .

Exclusion criteria

Exclusion Criteria:

  • 1. Any evidence indicating the presence of CNS parenchymal, meningeal or intraocular lymphoma at the time of enrollment; 2. Having a history of myocardial infarction within 6 months prior to enrollment; suffering from (NYHA) grade 3 or 4 congestive heart failure, or having a history of NYHA grade 3 or 4 congestive heart failure in the past, unless the (LVEF) was ≥ 50% in the echocardiography (ECHO) screening conducted within 1 month before entering the study; 3. Pregnant or lactating women (baseline pregnancy test positive or not undergoing pregnancy test for women of childbearing age. women must be at least 12 months post-menopause); 4. Having an uncontrollable infection; 5. Any other situation that the investigator deems the patient is not suitable to participate in this trial.
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

05

Study design

Phase
Phase 2
Primary purpose
Prevention
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
87 participants (estimated)

Study arms

  • Experimental
    Patients with diffuse large B-cell lymphoma who meet the criteria for high-risk central nervous syst

    At least one of the following high-risk factors for CNS recurrence must be present: CNS-IPI score ≥ 4; or involving specific extranodal sites (such as testis, breast, adrenal gland, kidney, uterus, bone marrow, high-risk bones); or having ≥ 2 extranodal invasion sites.

    Drug: Lenalidomide · Drug: Bruton's tyrosine kinase inhibitor · Drug: Chidamide

Interventions

  • The dosage of lenalidomide is 25mg each time, once daily, taken with food or on an empty stomach. It is administered continuously from day 1 to day 21, with each 28-day period as one cycle. For elderly patients (aged \> 75 years) or those with reduced renal function (creatinine clearance rate \< 60 ml/min), the starting dose is reduced to 15mg. During the lenalidomide treatment, aspirin 100mg once daily or low molecular weight heparin is used to prevent thrombosis. The preventive drugs can be initiated simultaneously with chemotherapy or started 4-6 weeks after the completion of chemotherapy for continuous prevention, which is determined by the investigator. After the chemotherapy, it enters the single-agent maintenance stage, with the total prevention medication duration of 1 year (counting from the first administration), or until disease progression, intolerable toxicity occurs, or informed consent is withdrawn.

  • DrugBruton's tyrosine kinase inhibitor

    The BTK inhibitor group includes drugs such as Zanubrutinib, Obinutinib, and Ibrutinib. Their specific usage is as follows: Zanubrutinib, 160mg each time, taken twice daily before or after meals; Ibrutinib, 560mg each time, once daily, taken before or after meals; Obinutinib, 150mg each time, once daily, taken before or after meals. Preventive drugs can be initiated simultaneously with chemotherapy or started 4-6 weeks after the completion of chemotherapy, depending on the decision of the researchers. After the completion of chemotherapy, it enters the single-agent maintenance stage. The total preventive medication duration is 1 year (counting from the first administration), or until disease progression, intolerable toxicity occurs, or informed consent is withdrawn.

  • Chidamide is administered at a dose of 20mg every 21 days. The medication is taken on days 1, 4, 8, and 11 of each cycle, 30 minutes after meals. The preventive medication can be initiated simultaneously with chemotherapy or started 4-6 weeks after the completion of chemotherapy, depending on the decision of the investigator. After the chemotherapy is completed, it enters the single-agent maintenance phase. The total preventive medication duration is 1 year (counting from the first administration), or until disease progression, intolerable toxicity occurs, or informed consent is withdrawn.

06

What researchers measure

Primary outcomes

  1. Two-year cumulative recurrence rate of CNS

    The cumulative proportion of patients who experienced central nervous system recurrence within 2 years after starting the trial drug treatment.

    Time frame: The cumulative proportion of patients who experienced central nervous system recurrence within 2 years after starting the trial drug treatment.

Secondary outcomes

  1. Progression-Free Survival (PFS)

    From the time the experimental drug was administered until the date of the first recorded disease progression (in the central nervous system or systemically), recurrence, or death for any reason.

    Time frame: From enrollment to the end of treatment until 2 years

  2. Overall survival (OS)

    OS was defined as the time from cytarabine and thalidomide initiation to death or last follow-up.

    Time frame: From enrollment to the end of treatment until 1 years

Other outcomes

  1. FACT-G (Functional Assessment of Cancer Therapy-General)

    Score of FACT-G (Functional Assessment of Cancer Therapy-General)

    Time frame: From enrollment to the end of treatment until 3 years

  2. Correlation between circulating free DNA (cfDNA) and efficacy

    Correlation between circulating free DNA (cfDNA) and efficacy

    Time frame: From enrollment to the end of treatment until 3 years

07

Study locations

1 site
  • Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College,
    Beijing, China
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Nov 2026; primary completion for Oct 2028, 23 months later.

Of 210 non-industry phase 2 interventional studies under Lymphoma, Large B-Cell, Diffuse, half reached primary completion within 57 months of starting (the median), counting those still running; a quarter within 40 and three quarters within 96. This study's planned 23 months is below that.

Counting every sponsor, half of 264 studies reached it within 52 months; a quarter within 35 and three quarters within 85.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 30, 2026
First posted
Nov 4, 2026
StartEst.
Nov 1, 2026
Primary completionEst.
Oct 31, 2028
CompletionEst.
Nov 1, 2028
Last update
Nov 4, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Registered
First appeared on the registry. No changes since
Nov 4, 2026
Show all 1 update
  1. Nov 4, 2026
    First appeared on the registry

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07917624
Responsible party
Sponsor
First posted
Nov 4, 2026
Start date
Nov 1, 2026 (estimated)
Primary completion
Oct 31, 2028 (estimated)
Completion
Nov 1, 2028 (estimated)
Last update
Nov 4, 2026

Study contacts

XinXin XX Cao
Contact
caoxinxin@126.com
+86-18618315968

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Oct 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Lenalidomide · Tucidinostat

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