SYS6002 vs Chemotherapy in Patients With Locally Advanced or Metastatic Urothelial Carcinoma

A Randomized, Controlled, Open-Label, Multicenter Phase 3 Trial of SYS6002 Versus Investigator's Choice Chemotherapy in Patients With Locally Advanced or Metastatic Urothelial Carcinoma After Failure of Platinum-based Chemotherapy andPD-(L)1 Inhibitors

This study is a randomized, controlled, open-label, multicenter phase III clinical trial, which aims to evaluate the efficacy,safety PK characteristics, and immunogenicity of SYS6002 compared with chemotherapy in participants with locally advanced or metastatic urothelial carcinoma.

This study has not yet been submitted for ethical review. The current registration is a pre-registration. Recruitment will commence only after formal approval is obtained from the relevant Ethics Committee).

Study Overview

• Status: Not yet recruiting
• Conditions: Urothelial Carcinoma
• Intervention / Treatment: Drug: SYS6002; Drug: Investigator's Choice of Chemotherapy

• Study Type: Interventional
• Enrollment (Estimated): 406
• Phase: Phase 3

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 1.Participantss aged 18-75 years (inclusive);
• 2. Pathologically confirmed patients with locally advanced or metastatic urothelial carcinoma
• 3 Participants havefailed of platinum-based chemotherapy and PD-(L)1 inhibitors; for participants who received platinum-based chemotherapy and PD-(L)1 inhibitors in the adjuvant/neoadjuvant setting, disease recurrence or progression must have occurred within 12 months after completion of that therapy; radiographically confirmed disease progression during or after the most recent treatment regimen;
• 4 Participants must have measurable disease according to RECIST (version 1.1);
• 5 Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
• 6 Life expectancy of ≥ 3 months;
• 7 Adequate major organ function (hematology, renal, liver, and coagulation) as determined by laboratory tests performed within 7 days prior to treatment;
• 8 Sexually active fertile participants must agree to use methods of contraception during the study and at least 6 months after termination of study therapy and have a negative urine or serum pregnancy test within 7 days prior to randomization;
• 9 Willing to participate in the study, understand the study procedures, and sign a written informed consent form.

Exclusion Criteria:

• 1. Active central nervous system metastases or leptomeningeal metastasis;
• 2. Prior Nectin-4-targeted therapy;
• 3. Adverse events from prior antitumor therapy not recovered to Grade ≤ 1 per NCI-CTCAE v5.0；

• 4. Any serious and/or uncontrolled concurrent illness that may interfere with patient's participation in the study:

  1. History of severe cardiovascular disease within 6 months prior to randomization, including but not limited to:

     1. Severe cardiac rhythm or conduction abnormalities, such as ventricular arrhythmia and third-degree atrioventricular block requiring clinical intervention; corrected QT interval > 480 ms by Fridericia method (Fridericia formula: QTcF = QT/RR^0.33, RR = 60/heart rate);
     2. With history of myocardial infarction, unstable angina pectoris, angioplasty and coronary artery bypass surgery;
     3. New York Heart Association (NYHA) classification Grade III and above heart failure, and left ventricular ejection fraction (LVEF) < 50% in the tests and examinations during the screening period;
     4. Ischemic or Hemorrhagic Stroke;
     5. Pulmonary Embolism Accident;

  2. Other clinically significant diseases:

     1. HbA1c > 8%;
     2. Participants with active keratitis and corneal ulcer, or fundus lesions with a risk of blindness;
     3. Grade ≥2 neuropathy prior to randomization;
     4. Severe infection within 4 weeks prior to randomization; Active infection of Grade ≥2 (CTCAE v5.0) requiring systemic antibiotics, antivirals, or antifungals within 2 weeks prior to randomization;
     5. Active HBV or HCV infection;
     6. History of immunodeficiency (HIV-positive, acquired or congenital immunodeficiency, etc.), or organ transplantation;
     7. History of another malignancy within 3 years prior to randomization;
     8. History of interstitial lung disease (ILD) / non-infectious pneumonia, or current ILD/non-infectious pneumonia, or imaging findings at screening that cannot rule out these condition, except for those who are determined to be risk-free after discussion between the investigator and the sponsor;
     9. Pleural effusion, ascites or pericardial effusion with syptoms or requiring puncture or drainage within 2 weeks prior to randomization;
• 5. Use of other unmarketed clinical investigational drugs or treatments, chemotherapy, radiotherapy, or targeted therapy within 4 weeks prior to randomization; use of traditional Chinese medicine with anticancer indication, oral fluoropyrimidine drugs, small molecule targeted drug within 2 weeks prior to randomization; use of palliative radiation or local therapy within 2 weeks prior to randomization; or major surgery within 4 weeks prior to randomization;
• 6. Allergy to any component of SYS6002 or to humanized monoclonal antibodies;
• 7. Other conditions deemed by the investigator as unsuitable for participation in this clinical trial.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SYS6002; SYS6002 monotherapy	Drug: SYS6002; SYS6002 by intravenous (IV)
Active Comparator: Chemotherapy; Investigator's choice of one of chemotherapy treatment (docetaxel, paclitaxel or pemetrexed)	Drug: Investigator's Choice of Chemotherapy; Investigator's choice of chemotherapy means the chemotherapy chosen by investigators to treat urothelial carcinoma including docetaxel (75 mg/m^2 by IV on Day 1, every 21 days),paclitaxel (175 mg/m^2 by IV on Day 1, every 21 days)or pemetrexed (500 mg/m^2 by IV on Day 1, every 21 days) ).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall Survival	Overall survival is defined as the time from the date of randomization to the date of death due to any cause. In the absence of confirmation of death, survival time will be censored at the last date the participant is known to be alive.	Up to approximately 3 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of adverse events		Up to 3 years
Incidence of Anti-Drug Antibody (ADA)		Up to 3 years
Disease Control Rate (DCR)	The percentage of participants who experience a best response of CR, PR or stable disease (SD).	Up to 3 years
Objective Response Rate (ORR)	Objective response rate is defined as the percentage of participants with a confirmed complete response (CR) or partial response (PR) per RECIST v.1.1.	Up to 3 years
Duration of Response (DOR)	DOR is defined as the time from the date of the first confirmed objective response (CR or PR that is subsequently confirmed) to the date of the first documented disease progression (PD) per RECIST v1.1 or death from any cause, whichever occurs first	Up to 3 years
Progression Free Survival (PFS)	PFS is defined as the time from the date of randomization to the first documentation of PD as assessed by investigator per RECIST v.1.1, or death due to any cause, whichever occurs earlier.	Up to 3 years
Blood concentration of SYS6002		Up to 3 years

Collaborators and Investigators

• Sponsor: CSPC Megalith Biopharmaceutical Co.,Ltd.

Study record dates

Study Major Dates

• Study Start (Estimated): June 20, 2026
• Primary Completion (Estimated): June 1, 2029
• Study Completion (Estimated): December 1, 2029

Study Registration Dates

• First Submitted: April 7, 2026
• First Submitted That Met QC Criteria: April 7, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 7, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms; Neoplasms by Histologic Type; Neoplasms, Glandular and Epithelial; Carcinoma; Carcinoma, Transitional Cell
• Other Study ID Numbers: SYS6002-004

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No