BL-M07D1 (Trastuzumab Brengitecan T-bren) vs Standard of Care Platinum-based Chemotherapy (PBC) for HER2-expressing Metastatic Urothelial Cancer After Progression on Anti-PD-(L)1-based Therapy

November 9, 2026 updated by: SystImmune Inc.

A Phase 3 Open-Label, Randomized Controlled Trial of T-bren (BL M07D1) vs. Platinum-based Chemotherapy in Patients With HER2 Expressing Metastatic Urothelial Cancer With Disease Progression on or After Anti-PD-(L)1-based Therapy

The objective of the study is to evaluate the efficacy and safety of T-bren in participants with HER2 expressing metastatic UC with progression on or after anti-PD-(L)1-based therapy.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This study is a Global Phase 3, randomized, open-label, multicenter study of T-bren for the treatment of metastatic UC. This study will assess the efficacy and safety of T-bren versus PBC in adult participants with HER2-expressing UC after progression on anti-PD-(L)1-based therapy.

Study Type

Interventional

Enrollment (Estimated)

520

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Georgia
      • Macon, Georgia, United States, 31210
        • Recruiting
        • Central Georgia Cancer Center
        • Principal Investigator:
          • Bradley Sumrall, MD
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Histologically or cytologically documented metastatic or surgically unresectable transitional cell carcinoma (TCC) of the urothelium involving the renal pelvis, ureter, bladder, or urethra. Minor histologic variants (ie, <50% overall) are acceptable, provided that TCC is the dominant histology.
  • Disease progression or recurrence during or following anti-PD-(L)1-based therapy.
  • Fresh biopsy or archival tumor samples.
  • Documented HER2 expression by central laboratory testing.
  • Eligible to receive carboplatin or cisplatin in combination with gemcitabine.
  • At least 1 measurable lesion based on RECIST v1.1.
  • An Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 to 1.
  • Adequate organ function.
  • Adequate coagulation parameters.

Exclusion Criteria:

  • Prior topoisomerase inhibitor-based ADC therapy.
  • Primary tumors in the central nervous system (CNS), active or untreated CNS metastases, or carcinomatous meningitis.
  • Bladder cancers with small cell histology.
  • Other prior or concurrent malignancies except for certain localized cancers or low-grade prostate cancer (if approved by sponsor), or other malignancy treated with curative intent with a disease-free interval of at least 3 years.
  • Prior history of clinically significant bleeding, or perforation of the gastrointestinal tract within 6 months of randomization.
  • Active autoimmune diseases and inflammatory diseases.
  • History of noninfectious interstitial lung disease (ILD)/pneumonitis that required treatment with steroids, have current ILD/pneumonitis, or where suspected ILD/pneumonitis cannot be ruled out by imaging at Screening.
  • Advanced/clinically significant lung disease (eg, poorly controlled chronic obstructive pulmonary disease or asthma, restrictive lung disease, or pulmonary hypertension) within 6 months prior to randomization.
  • Known human immunodeficiency virus infection.
  • Active hepatitis B virus (HBV) infection.
  • Active hepatitis C virus (HCV) infection.
  • Active or latent tuberculosis.
  • Other protocol-specified inclusion/ exclusion criteria apply

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm A, T-bren Dose Level 1

T-bren administered intravenously

T-bren: Administered intravenously on day 1 of each 21-day cycle

Other Names:
  • T-Bren
  • BL-M07D1
  • Trastuzumab Brengitecan
Experimental: Arm B, T-bren Dose Level 2

T-bren administered intravenously

TBren administered intravenously on day 1 of each 21-day cycle

Other Names:
  • T-Bren
  • BL-M07D1
  • Trastuzumab Brengitecan
Active Comparator: Arm C, Control Arm, Platinum-based Chemotherapy (PBC)
  1. Gemcitabine Administered intravenously
  2. Cisplatin or Carboplatin Administered intravenously

Gemcitabine administered intravenously on Day 1 and Day 8 of each 21-day cycle and Cisplatin or Carboplatin administered intravenously on Day 1 of each 21-day cycle

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Progression-Free Survival (PFS)
Time Frame: Approximately 5 years

Progression-Free Survival (PFS) by Blinded Independent Central Review (BICR) per RECIST v1.1 in the primary population

Approximately 5 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall Survival (OS)
Time Frame: Approximately 5 years

Overall Survival (OS) in primary population

Approximately 5 years
Progression-Free Survival (PFS) in the ITT population
Time Frame: Approximately 5 years

Progression-Free Survival (PFS) by BICR per RECIST v1.1 in the ITT (Intent-to-Treat) Population

Approximately 5 years
Overall Survival (OS) in the ITT population
Time Frame: Approximately 5 years
Approximately 5 years
Progression-Free Survival (PFS) by Investigator Assessment
Time Frame: Approximately 5 years

Progression-Free Survival (PFS) by Investigator Assessment per RECIST v1.1

Approximately 5 years
Objective Response Rate (ORR) per RECIST v1.1
Time Frame: Approximately 5 years
Approximately 5 years
Disease Control Rate (DCR) per RECIST v1.1
Time Frame: Approximately 5 years
Approximately 5 years
Duration of Response (DOR) per RECIST v1.1
Time Frame: Approximately 5 years
Approximately 5 years
Time to Response (TTR) per RECIST v1.1
Time Frame: Approximately 5 years
Approximately 5 years
Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time Frame: Approximately 5 years
Approximately 5 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Director: Jimmy Liu Zhao, MD, PhD, SystImmune Inc.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 1, 2026

Primary Completion (Estimated)

December 1, 2028

Study Completion (Estimated)

December 1, 2029

Study Registration Dates

First Submitted

October 6, 2026

First Submitted That Met QC Criteria

October 6, 2026

First Posted (Actual)

October 13, 2026

Study Record Updates

Last Update Posted (Actual)

November 10, 2026

Last Update Submitted That Met QC Criteria

November 9, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.