B-Cell Lymphoma

The aim of the DIRECT Study was to establish a robust pipeline to identify those patients with high-grade B cell lymphoma most suitable for novel agent clinical trials based upon genomic subtype and an integrated response evaluation determined early in first-line therapy.

This has been done by integrating data and samples collected from patients undergoing standard of care treatment for high-grade B cell lymphoma.

The trial was funded jointly by AstraZeneca and the Cancer Research UK Cambridge Centre as well as being a flagship trial for MFICM. The trial has now closed to recruitment.

Data will be integrated from

1. Clinical risk factors from the International Prognostic Index (IPI)
2. Up-front genomic subtype based on molecular profiling of diagnostic biopsy
3. Serial ctDNA monitoring during treatment.
4. Radiological response imaging

Clinical trial registration

Krupka, J.A., et al, Phased Variant–Supported Circulating Tumor DNA as a Prognostic Biomarker After First-Line Treatment in Large B-Cell Lymphoma: Findings From the DIRECT Study, Journal of Clinical Oncology, December 2025.