CSF DNA testing to improve diagnosis and monitoring in primary CNS lymphoma

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a prospective, low-intervention effort to create a core panel of genetic alterations by sequencing cell-free DNA in cerebrospinal fluid (CSF) from patients with confirmed or suspected primary CNS lymphoma (PCNSL). Participants will undergo lumbar puncture for CSF collection and have available histopathology and imaging data; sequencing results will be compared to standard diagnostic and response measures. Enrolled patients will receive standard-of-care treatments and the molecular data will not change treatment choices. The goal is to improve diagnostic sensitivity, track objective responses, and detect early CNS relapse in routine practice.

Why it matters

Who can join: the full rules

Inclusion Criteria for study population:

1. Age ≥18 years
2. Newly diagnosed PCNSL with available clinical and radiological data, CSF and histopathological brain biopsy material fresh and/or formalin fixed and paraffin embedded;
3. No contraindications to stereotactic or open brain biopsy and lumbar puncture;
4. No formal contraindications to intravenous chemo-immunotherapy or whole-brain irradiation;
5. 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:

1. Patients with concomitant CNS and systemic involvement at presentation (potentially eligible as "control"; see below)
2. Patients with CNS lymphoma other than DLBCL subtype
3. Any other serious medical condition which could impair the ability of the patient to participate in the trial
4. Pregnant and lactating female patients. Sexually active patients of childbearing potential must implement adequate contraceptive measures during study participation.
5. 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.
6. Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.

Inclusion criteria for controls:

1. Age ≥18 years
2. 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.

6\. 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:

1. Patients with extra-CNS lymphoma other than DLBC or HGBC subtypes, and not classified as high risk of CNS relapse;
2. Any other serious medical condition which could impair the ability of the patient to participate in the trial;
3. Pregnant and lactating female patients. Sexually active patients of childbearing potential must implement adequate contraceptive measures during study participation;
4. 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;
5. Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.

Where it's running

• IRCCS Ospedale San Raffaele
  Milan, Italy/Lombardy, Italy Recruiting

Study contacts

• Principal investigator: Andrés J.M. Ferreri, MD — IRCCS Ospedale San Raffaele
• Study coordinator: Andrés J.M. Ferreri, MD
• Email: ferreri.andres@hsr.it
• Phone: 02 2643 7649

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.