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RecruitingLast updated: 19 May 2026

CLARIFY: This study is testing whether getting faster test results is possible, so that high-risk patients can be identified and put on appropriate treatment sooner, in people with large B-cell lymphomaNHL34: An ALLG National Platform Study (Master Protocol) for Identification and Early Intervention in Ultra-High-Risk Large B Cell Lymphoma

Trial purpose

Medical clipboardDiagnostic

Tumor type

Blood Cancers Haematological

Age

People18+

Trial acronym

CLARIFY

Clinical summary

Summary

Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive non-Hodgkin lymphoma (NHL), accounting for 30-40% of all NHL cases.

To assess the risk for DLBCL, doctors use tools like the International Prognostic Index (IPI), aaIPI, and NCCN-IPI. These tools help identify high-risk patients but are not good at spotting those at "ultra-high-risk" (UHR) of treatment failure within two years of diagnosis.

This study is a nationwide platform that offers real-time, centralised risk assessment for people with large B-cell lymphoma (LBCL) who are treated with frontline immuno-chemotherapy. This may help doctors make better treatment decisions, provide more accurate prognoses, and advance molecular and imaging techniques in Australia and New Zealand.

The study also aims to identify ultra high-risk LBCL patients for clinical trials of new treatments, creating an efficient and cost-effective framework for future lymphoma trials.

Who is it for?
You may be eligible for this study if you are aged 18 years or older and have been diagnosed with LBCL.

Study details
LBCL patients will commence standard of care immunotherapy regimen. They will have some tests (a FDG/PET scan and/or a MRD assay) at baseline, cycle 4, cycle 6, and 3 months after treatment ends. 

People with a positive disease result will be referred to relevant treatment arms of this study, depending on meeting the relevant criteria. A positive disease will be based on centralised baseline tumour sequencing, centralised delta standardised uptake value (SUV) quantification / Deauville score, and measurable residual disease (MRD) testing. 

A UHR LBCL patient population will be identified and referred to a relevant therapeutic arm of this study to test novel treatments such as CAR-T cell infusion.

This research aims to evaluate the feasibility of achieving faster turnaround rates for centralised MRD and FDG-PET reviews, to identify an UHR population to get them on appropriate treatment sooner. 

By meeting meeting the following benchmarks in real time, the study will significantly contribute to the field by enhancing the speed and accuracy of prognostic processes:

  • MRD analysis and report turnaround must be completed within 21 days from sample collection.
  • FDG-PET scan reports must be ready within 7 days for SUV/Deauville score at C4D15, C6D15, and 3 months after the end of treatment.

Conditions

This trial is treating people with a confirmed diagnosis of CD20 positive large B-cell lymphoma and are planned to receive frontline treatment with immunochemotherapy

Eligibility

Inclusion

1. Histologically confirmed diagnosis of CD20 positive large B cell lymphoma including diagnosis by 2022 WHO classification:
• DLBCL, not otherwise specified (NOS) including transformation from indolent lymphoproliferative disease
• T-cell/histiocyte-rich large B-cell lymphoma
• Epstein-Barr virus-positive DLBCL, NOS
• DLBCL/HGBCL with MYC and BCL2 rearrangements
• High-Grade B-Cell Lymphoma (HGBCL), NOS
• Follicular Large B Cell Lymphoma (FLBCL) (previously Grade 3B Follicular Lymphoma)
• High-risk pretreatment clinical prognostication by either
• Patients greater than 60-years: IPI Score greater than 3
• Patients less than 60-years: aaIPI Score 2-3
• Planned for frontline treatment with minimum 6 cycles of a combined immunochemotherapy regimen containing rituximab and anthracycline. These include: R-CHOP, DA-R-EPOCH, R-CHEOP, R-CHEP, R-Hyper-CVAD, Pola-R-CHP. Additional regimens may be approved on discussion with Co-PI
3. Eastern Cooperative Oncology Group Performance Status (ECOG) 0-2
4. Ability to provide tumour tissue; archival or freshly collected
5. Aged greater than 18 years old at the time of screening
6. Life expectancy (due to non-lymphoma related reasons) of at least 6-months
7. Available for follow-up for 2-years post EoT
8. Can provide written informed consent

Exclusion

1. Histological subtypes of LBCL including mediastinal grey zone lymphoma; primary mediastinal (thymic) large B-cell lymphoma; Burkitt lymphoma; primary large B-cell lymphoma of immune-privileged sites; primary effusion DLBCL; primary cutaneous DLBCL, leg type; Post-Transplant Lymphoproliferative Disease
2. Primary or secondary CNS lymphoma at the time of recruitment to the study
3. Prior therapy for lymphoproliferative disease, with the exception of:
a. Corticosteroids (100mg or equivalent for less than 14 days)
b. Radiotherapy to target lesions as consolidation is allowed provided intent and anatomical location of consolidative radiotherapy is prespecified prior to or at enrolment. Radiation prior to enrolment is not permitted.
c. Central Nervous System (CNS) Prophylaxis (intrathecal or high-dose methotrexate) may be provided at treating clinician discretion as per local guidelines.
4. Pregnancy or lactation
5. Active synchronous solid tumour malignancy (excluding non-melanoma skin cancers and localised renal cell carcinoma)
6. Severe active infection.
7. Has any other clinically important abnormalities as determined by the recruiting investigator that may interfere with participation in or compliance with the study.
8. Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule. This condition must be discussed with the patient prior to signing consent to the trial.

Inclusion

  • You have the type of cancer, symptoms, or health risks that this clinical trial is focused on.

Exclusion

  • You have been diagnosed with a prior or secondary type of cancer.
  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
Message

Clinical trials have complex eligibility criteria, and other criteria may apply for this trial. Ask your doctor about whether this trial could be right for you.

Participating hospitals

Recruiting hospitals

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More information

Trial Identifiers

Information on this page is partially produced from ANZCTR *. View further details about this trial on the registry via the links below:

Trial sponsor

Australasian Leukaemia and Lymphoma Group

Scientific Title

NHL34: An ALLG National Platform Study (Master Protocol) for Identification and Early Intervention in Ultra-High-Risk Large B Cell Lymphoma

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