An Open-label, Randomized, Multi-center, Phase III Clinical Study of MRG002 Versus Investigator's Choice of Chemotherapy in the Treatment of Patients With HER2-positive Unresectable Locally Advanced or Metastatic Urothelial Cancer Previously Treated With Platinum-based Chemotherapy and PD-1/PD-L1 Inhibitors
试验速览
- 阶段
- 3 期
- 状态
- 招募中
- 入组人数
- 290
- 试验地点
- 1
- 主要终点
- Progression-Free Survival (PFS) by Independent Review Committee (IRC)
研究概览
简要总结
The primary objective of this study is to compare the overall survival (OS) and progression-free survival (PFS) between MRG002 and investigator selected chemotherapy in patients with HER2-positive unresectable locally advanced or metastatic urothelial cancer previously treated with platinum-based chemotherapy and PD-1/PD-L1 inhibitors.
详细描述
This study aims to enroll 290 patients. Participants will be randomly assigned to receive treatment of MRG002 or investigator selected chemotherapy in a 1:1 ratio. The efficacy of MRG002 will be assessed by patient's OS, PFS and other indicators as compared to investigator selected chemotherapy. Additionally, this study will assess the pharmacokinetic profile, immunogenicity, safety, tolerability, and treatment compliance of MRG002.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Willing to sign the ICF and follow the requirements specified in the protocol.
- •Aged 18 to 75 (including 18 and 75), both genders.
- •Expected survival time ≥ 12 weeks.
- •Patients with unresectable locally advanced or metastatic urothelium cancer confirmed by histopathology.
- •Patients who have failed prior platinum-based chemotherapy and PD-1/PD-L1 inhibitors and have have progressive disease or recurrence on or after their most recent therapy.
- •Archival or biopsy tumor specimens should be provided (primary or metastatic).
- •HER2 positive (IHC 3+ or IHC 2+) in the tumor specimens confirmed by central laboratory test.
- •Patients must have measurable lesions according to the Response Evaluation Criteria in Solid Tumors (RECIST v1.1).
- •ECOG performance score 0 or
- •Prior anti-tumor treatment-related AEs (NCI-CTCAE v5.0 Criteria) have recovered to ≤ Grade 1 (except alopecia, Grade 2 hypothyroidism, non-clinically significant or asymptomatic laboratory abnormalities).
- •Organ function must meet the basic requirements.
- •Patients of childbearing potential must take effective contraceptive measures during the treatment and for 180 days after the last dose of treatment.
排除标准
- •History of hypersensitivity to any component of MRG002 or history of hypersensitivity of ≥ Grade 3 to trastuzumab.
- •Patients who have received ADC drugs, or prior taxane, gemcitabine, and pemetrexed for locally advanced or metastatic urothelial cancer; or have received investigational drugs from other clinical trials, chemotherapy, radiotherapy, targeted therapy, or immunotherapy within 4 weeks prior to the first dose; or have received Chinese medicine (herbal medicine) or Chinese patent medicine with anti-tumor indications within 2 weeks prior to the first dose; or have received strong CYP3A4 inhibitors within 2 weeks prior to the first dose or have current requirement of CYP3A4 inhibitors; or had major surgery within 4 weeks prior to the first dose without full recovery or planned surgery within 12 weeks after study treatment.
- •Patients with clinical symptoms such as plural, abdominal or pericardial effusion requiring puncture drainage.
- •Patients with central nervous system (CNS) metastasis and/or neoplastic meningitis.
- •Any severe or uncontrolled systemic diseases.
- •Patients with poorly controlled heart diseases.
- •Evidence of active infections, including but not limited to Hepatitis B, Hepatitis C, or human immunodeficiency virus (HIV) infection.
- •History of other primary malignancies.
- •History of interstitial pneumonia, severe chronic obstructive pulmonary disease, severe pulmonary insufficiency, symptomatic bronchospasm, etc.
- •Peripheral neuropathy greater than Grade
- •History of cirrhosis.
- •Patients with active autoimmune disease or a history of autoimmune disease, who are using immunosuppressive agents, or systemic hormone therapy and still receiving them within 2 weeks prior to enrollment.
- •Uncontrolled tumor-associated bone pain or urgent spinal cord compression. Patients requiring pain control must have been on a stable treatment regimen for at least 2 weeks at the time of first dose
- •Other conditions inappropriate for participation in this clinical trial, at the discretion of the investigator.
研究组 & 干预措施
MRG002
MRG002 will be administrated by an IV infusion of 2.2 mg/kg on Day 1 of every 3 weeks (21-day cycle).
干预措施: Docetaxel Injection (Drug)
MRG002
MRG002 will be administrated by an IV infusion of 2.2 mg/kg on Day 1 of every 3 weeks (21-day cycle).
干预措施: Paclitaxel Injection (Drug)
MRG002
MRG002 will be administrated by an IV infusion of 2.2 mg/kg on Day 1 of every 3 weeks (21-day cycle).
干预措施: Gemcitabine Hydrochloride for Injection (Drug)
MRG002
MRG002 will be administrated by an IV infusion of 2.2 mg/kg on Day 1 of every 3 weeks (21-day cycle).
干预措施: Pemetrexed Disodium Injection (Drug)
Docetaxel /Paclitaxel /Gemcitabine Hydrochloride /Pemetrexed Disodium Injection
Docetaxel injection will be administered by an IV infusion of 75 mg/m2 on Day 1 of every 3 weeks (21-day cycle); Paclitaxel will be administrated by an IV infusion of 175 mg/m2 on Day 1 of every 3 weeks (21-day cycle).
Gemcitabine Hydrochloride will be administrated by an IV infusion of 1000 mg/m2 on Day 1 and Day 8 of every 3 weeks (21-day cycle).
Pemetrexed Disodium will be administrated by an IV infusion of 500 mg/m2 on Day 1 of every 3 weeks (21-day cycle).
干预措施: MRG002 (Drug)
结局指标
主要结局
Progression-Free Survival (PFS) by Independent Review Committee (IRC)
时间窗: Baseline to study completion (up to 36 months)
PFS is defined as the duration from the date of randomization to the onset of tumor progression or death of any cause.
Overall Survival (OS)
时间窗: Baseline to study completion (up to 36 months)
OS is defined as the time from the date of randomization until death of any cause.
次要结局
- Disease Control Rate (DCR)(Baseline to study completion (up to 36 months))
- PFS by investigator(Baseline to study completion (up to 36 months))
- Clinical Benefit Rate (CBR)(Baseline to study completion (up to 36 months))
- Objective Response Rate (ORR)(Baseline to study completion (up to 36 months))
- Time to Response (TTR)(Baseline to study completion (up to 36 months))
- Duration of Response (DoR)(Baseline to study completion (up to 36 months))
- Anti-drug antibody (ADA)(Baseline to 7 days after discontinuation of treatment)
- Adverse Events (AEs)(Baseline to 30 days after the last dose of study treatment)
- Neutralizing antibody (NAb)(Baseline to 7 days after discontinuation of treatment)
- Pharmacokinetics (PK) Parameter of MRG002: concentration-time curve(Baseline to 7 days after discontinuation of treatment)