Loncastuximab Tesirine + Rituximab for PTLD
(PLUTO Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial tests two drugs, loncastuximab tesirine and rituximab, to determine the best dose and assess their effectiveness for people with post-transplant lymphoproliferative disorders (PTLD), a condition that can develop after an organ transplant. In the first part of the trial, researchers aim to identify the optimal dosage. The second part evaluates the effectiveness of these drugs in treating PTLD. Individuals with PTLD following a solid organ transplant, confirmed through a medical diagnosis, might be eligible for this study. As a Phase 1/Phase 2 trial, the research focuses on understanding how the treatment works in people and measuring its effectiveness in an initial, smaller group.
Do I need to stop my current medications for the trial?
The trial requires a washout period (time without taking certain medications) for any prohibited medications, lasting at least five half-lives of the medication or as clinically indicated. It's best to discuss your current medications with the trial team to see if any are prohibited.
Is there any evidence suggesting that this trial's treatments are likely to be safe?
Research shows that the combination of loncastuximab tesirine and rituximab is generally safe. Studies have found that most patients tolerate the treatment well, with side effects that are usually manageable. In one study involving patients with relapsed or hard-to-treat follicular lymphoma, this treatment proved both effective and safe, with most participants responding positively. Additionally, other studies have confirmed that loncastuximab tesirine, also known as ZYNLONTA®, is generally well-tolerated. While side effects can occur, they are often mild and treatable. Overall, the evidence suggests these treatments are safe for most people.12345
Why are researchers excited about this trial's treatments?
Researchers are excited about Loncastuximab Tesirine combined with Rituximab for treating post-transplant lymphoproliferative disorder (PTLD) because it introduces a novel approach. Unlike standard treatments like R-CHOP or monotherapy with Rituximab, Loncastuximab Tesirine is an antibody-drug conjugate that delivers a potent cytotoxic agent directly to the cancer cells, sparing more of the healthy cells. This targeted mechanism could lead to more effective outcomes with potentially fewer side effects. Additionally, the combination with Rituximab enhances the treatment's ability to specifically target and destroy B-cell malignancies, which could significantly improve the prognosis for patients with PTLD.
What evidence suggests that this trial's treatments could be effective for PTLD?
This trial will evaluate the combination of two drugs, loncastuximab tesirine and rituximab, for treating post-transplant lymphoproliferative disorders (PTLD). Studies have shown that rituximab alone may not always be effective, but adding loncastuximab tesirine, which specifically targets cancer cells, can lead to better outcomes. For example, some studies have demonstrated that this combination controls tumors more effectively. Participants in this trial will receive different dose levels of this combination, and researchers will assess their responses to determine the treatment's effectiveness. This approach has shown promise in past trials, suggesting it could be a strong option for treating PTLD.12456
Who Is on the Research Team?
Narendranath Epperla, MD
Principal Investigator
Huntsman Cancer Institute
Are You a Good Fit for This Trial?
This trial is for adults (18+) who have B-cell post-transplant lymphoproliferative disorder (PTLD) after a solid organ transplant. Participants must have measurable disease, good blood counts, and adequate liver function. People with classic Hodgkin-like PTLD or poor overall health cannot join.Inclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Phase I Treatment
Determine the recommended dose of loncastuximab tesirine and rituximab in participants with PTLD
Phase II Treatment
Assess the efficacy of loncastuximab tesirine and rituximab in participants with PTLD
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- Loncastuximab Tesirine
- Rituximab
Trial Overview
The study is testing the combination of two drugs—loncastuximab tesirine and rituximab—as first treatment for PTLD. The trial will find the best dose and see how well this drug combo works in these patients.
How Is the Trial Designed?
6
Treatment groups
Experimental Treatment
Dose Level 2: * Loncastuximab tesirine: 0.15 mg/kg IV every 3 weeks for the first 2 cycles, then 0.075 mg/kg starting C3 * Rituximab: 375 mg/m2 IV This arm included participants who had SD (Stable Disease) or PD (Progressive Disease) after the first 6 weeks of treatment. Lonca-R will be administered for 4 cycles with response assessment at 6 weeks (+/- 1 week) following the last Lonca-R treatment. If they do not achieve a response, they will come off the study but will be monitored for survival.
Dose Level 2: * Loncastuximab tesirine: 0.15 mg/kg IV every 3 weeks for the first 2 cycles, then 0.075 mg/kg starting C3 * Rituximab: 375 mg/m2 IV This arm included participants who had a Partial Response (PR) after the first 6 weeks of treatment. Lonca-R will be administered for 4 cycles with response assessment at 6 weeks (+/- 1 week) following the last Lonca-R treatment. If they achieve PR, they will have the option to receive either rituximab consolidation or R-CHOP (at the physician's discretion).
Dose Level 2: * Loncastuximab tesirine: 0.15 mg/kg IV every 3 weeks for the first 2 cycles, then 0.075 mg/kg starting C3 * Rituximab: 375 mg/m2 IV This arm included participants who had a Complete Response (CR) after the first 6 weeks of treatment. Lonca-R will be administered for 4 cycles with response assessment at 6 weeks (+/- 1 week) following the last Lonca-R treatment. If they achieve a CR after 4 cycles of Lonca-R, they will receive rituximab consolidation (SOC).
Dose Level 1: * Loncastuximab tesirine: 0.075 mg/kg IV every 3 weeks * Rituximab: 375 mg/m2 IV This arm included participants who had SD (Stable Disease) or PD (Progressive Disease) after the first 6 weeks of treatment. Lonca-R will be administered for 4 cycles with response assessment at 6 weeks (+/- 1 week) following the last Lonca-R treatment. If they do not achieve a response, they will come off the study but will be monitored for survival.
Dose Level 1: * Loncastuximab tesirine: 0.075 mg/kg IV every 3 weeks * Rituximab: 375 mg/m2 IV This arm included participants who had a Partial Response (PR) after the first 6 weeks of treatment. Lonca-R will be administered for 4 cycles with response assessment at 6 weeks (+/- 1 week) following the last Lonca-R treatment. If they achieve PR, they will have the option to receive either rituximab consolidation or R-CHOP (at the physician's discretion).
Dose Level 1: * Loncastuximab tesirine: 0.075 mg/kg IV every 3 weeks * Rituximab: 375 mg/m2 IV This arm included participants who had a Complete Response (CR) after the first 6 weeks of treatment. Lonca-R will be administered for 4 cycles with response assessment at 6 weeks (+/- 1 week) following the last Lonca-R treatment. If they achieve a CR after 4 cycles of Lonca-R, they will receive rituximab consolidation (SOC).
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of Utah
Lead Sponsor
ADC Therapeutics S.A.
Industry Sponsor
Citations
Loncastuximab Tesirine and Rituximab as First-line ...
The purpose of phase II of this clinical trial is to learn if the drugs loncastuximab tesirine and rituximab are effective in participants with ...
Management of Diffuse Large B-Cell Lymphoma as Post ...
Single-agent rituximab was insufficient, but combination chemotherapy and novel agents like loncastuximab tesirine were effective. Balancing ...
3.
withpower.com
withpower.com/trial/phase-2-post-transplant-lymphoproliferative-disorder-5-2026-da9d0Loncastuximab Tesirine + Rituximab for PTLD (PLUTO Trial)
The purpose of phase I of this clinical trial is to learn the recommended dose of the drugs loncastuximab tesirine and rituximab in ...
Phase 3 randomized study of loncastuximab tesirine in ...
Preclinical evidence suggests that the addition of rituximab to anti-CD19 ADC therapy may result in prolonged tumor control (Ryan et al. Blood 2017). LOTIS-5 ...
5.
adctmedical.com
adctmedical.com/wp-content/uploads/tmp_veeva_files/Loncastuximab_(ZYNLONTA)_-_CD19_Expression_and_Sequencing_00P000000005001_9302.pdfSequencing of CD19-Directed Therapies for the Treatment of ...
ZYNLONTA® (loncastuximab tesirine-lpyl) is indicated for the treatment of adult patients with relapsed or refractory large B-cell lymphoma ...
6.
adctmedical.com
adctmedical.com/wp-content/uploads/tmp_veeva_files/Loncastuximab_(ZYNLONTA)_-_Renal_Safety_and_PTLD_00P000000005001_137.pdfZYNLONTA® (loncastuximab tesirine-lpyl) – Renal Safety and ...
Summary. • LOTIS-1 was the first-in-human Phase 1, open-label, single-arm, multicenter study that evaluated the safety and tolerability of ...
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