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Recruiting

NCT Number: NCT05036564

Diagnosis; Objective RespOnse; THErApy

Thi is a prospective and low-intervention clinical trial. We propose to design a panel of "core" genetic alterations by sequencing Cerebral Spinal Fluid (CSF) DNA in patients with confirmed or suspicious Primary Central Neurvous System Lymphoma (PCNSL) with the aim to improve diagnostic sensitivity, response assessment and monitoring early CNS relapse in routine practice.

Enrolled patients will receive conventional treatments according to well-established international guidelines, DNA assessments will not influence the treatment choices.

Recruiting

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

IRCCS Ospedale San Raffaele

Milan, Italy/Lombardy, 20132, Italy

Location status: Recruiting

Location contact

Andrés J.M. Ferreri, MD

CONTACT

[email protected]

02 2643 7649

Andrés J.M. Ferreri, MD

PRINCIPAL_INVESTIGATOR

Sara Steffanoni, MD

SUB_INVESTIGATOR

Teresa Calimeri, MD/PhD

CONTACT

[email protected]

02 2643 7612

Teresa Calimeri, MD/PhD

SUB_INVESTIGATOR

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

for study population:

  • Age ≥18 years
  • Newly diagnosed PCNSL with available clinical and radiological data, CSF and histopathological brain biopsy material fresh and/or formalin fixed and paraffin embedded;
  • No contraindications to stereotactic or open brain biopsy and lumbar puncture;
  • No formal contraindications to intravenous chemo-immunotherapy or whole-brain irradiation;
  • Given written informed consent prior to any study specific procedures, with the understanding that the patient has the right to withdraw from the study at any time, without any prejudice.

Exclusion criteria

for study population:

  • Patients with concomitant CNS and systemic involvement at presentation (potentially eligible as "control"; see below)
  • Patients with CNS lymphoma other than DLBCL subtype
  • Any other serious medical condition which could impair the ability of the patient to participate in the trial
  • Pregnant and lactating female patients. Sexually active patients of childbearing potential must implement adequate contraceptive measures during study participation.
  • Previous or concurrent malignancies at other sites diagnosed or relapsed within the last 3 years before PCNSL diagnosis. Patients with surgically cured in situ carcinomas and basal cell carcinoma of the skin are allowed.
  • Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.

Inclusion criteria

for controls:

  • Age ≥18 years
  • Newly diagnosed DLBCL with a high risk for relapse/progression in the CNS or High-grade B-cell (HGBC) lymphoma with available clinical and radiological data, CSF and diagnostic histopathological specimen. 3. Newly diagnosed and/or relapsed SCNSL with available clinical and radiological data, CSF and diagnostic histopathological specimen. 4. Newly diagnosed lymphoma confined to CNS other than DLBC subtype 5. Neoplastic and non-neoplastic neurological disorders (neurodegenerative and neuroinflammatory disorders, toxic or infective encephalitis, primary CNS tumors other than lymphomas (mainly gliomas)) with available clinical and radiological data, CSF samples and, where possible, histo-pathological brain biopsy material formalin fixed and paraffin embedded.
  • No contraindications to stereotactic or open brain biopsy and lumbar puncture; 7. Given written informed consent prior to any study specific procedures, with the understanding that the patient has the right to withdraw from the study at any time, without any prejudice.

Exclusion criteria

for controls:

  • Patients with extra-CNS lymphoma other than DLBC or HGBC subtypes, and not classified as high risk of CNS relapse;
  • Any other serious medical condition which could impair the ability of the patient to participate in the trial;
  • Pregnant and lactating female patients. Sexually active patients of childbearing potential must implement adequate contraceptive measures during study participation;
  • Previous or concurrent malignancies at other sites diagnosed or relapsed within the last 3 years of follow-up. Patients with surgically cured in situ carcinomas and basal cell carcinoma of the skin are allowed;
  • Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.

Treatment and study plan

Lumbar Puncture

Procedure

A lumbar puncture (spinal tap) is performed in patient lower back, in the lumbar region.

During a lumbar puncture, a needle is inserted between two lumbar bones (vertebrae) to remove a sample of cerebrospinal fluid (CSF). This is the fluid that surrounds brain and spinal cord to protect them from injury.

This procedure is usually performed at the time of diagnosis for disease staging and/or repeated in the course of the disease history, only if positive or for clinical reasons (i.e. suspicious of relapse progression).

In this study sequential CSF and peripheral blood samples of study population will be collected also at different time points, with the aim to improve diagnostics sensitivity, response assessment and monitoring early CNS relapse.

Primary outcomes

  1. Association between recurrent genetic alterations and PCNSL diagnosis or relapse

    Time frame: 3 years and 6 months

    Frequency of various genetic mutations among enrolled patients at diagnosis or relapse

  2. Association between recurrent genetic alterations and residual enhanced and not-enhanced images at the MRI

    Time frame: 3 years and 6 months

    Frequency of various genetic mutations among enrolled patients during treatment

Study contacts

Contact information is provided by the study sponsor or research team.

Andrés J.M. Ferreri, MD

CONTACT

[email protected]

02 2643 7649

Teresa Calimeri, MD/PhD

CONTACT

[email protected]

02 2643 7612

Sponsors and collaborators

Lead sponsor

IRCCS San Raffaele

Other

Collaborators

  • Sara Steffanoni
  • Teresa Calimeri

Registry information

Official study title

Mutational Analysis in the Cerebrospinal Fluid to Improve Diagnostic Sensitivity, Response Definition and Precision Treatment in Primary Central Nervous System Lymphoma

Acronym: DOROTHEA

Important dates

Study start
2020
Primary completion
2026
Study completion
2027
First posted
Sep 5, 2021
Registry last updated
May 31, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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