一项关于Becotatug Vedotin联合Pucotenlimab治疗EGFR阳性晚期阴茎癌的研究
一项多中心、单臂、探索性研究:评估Becotatug Vedotin联合Pucotenlimab治疗对化疗不耐受或化疗失败的EGFR阳性晚期阴茎癌患者
Penile cancer is a rare malignant tumor of the male genitourinary system, with 95% being squamous cell carcinoma. Due to social factors, delayed diagnosis is common, leading to a high rate of lymph node metastasis (17%-45% at diagnosis), which significantly impairs quality of life and prognosis. The 5-year survival rate is 27% for patients with lymph node metastasis and 0%-17% for those with pelvic lymph node metastasis (N3).
Current standard treatments recommended by guidelines include surgery and chemotherapy. However, the neoadjuvant TIP regimen (paclitaxel + ifosfamide + cisplatin) in locally advanced disease yields an objective response rate (ORR) of 50%, pathological complete response (pCR) rate of 10%, median progression-free survival (PFS) of 8.1 months, and median overall survival (OS) of 17.1 months. For advanced patients, no standard effective treatments exist after platinum-based chemotherapy resistance, highlighting an urgent need for more effective combination therapies.
High expression of PD-L1 (30%-70%) and EGFR (40%-80%) is common in penile squamous cell carcinoma, especially in poorly differentiated, late-stage disease with lymph node metastasis. A prospective phase II study showed that toripalimab (immunotherapy) combined with nimotuzumab (anti-EGFR antibody) and paclitaxel-based chemotherapy, followed by consolidation surgery, achieved an ORR of 82.8%, pCR rate of 48.3%, 2-year OS rate of 72.4%, and 2-year PFS rate of 65.5%; 41.4% of patients had grade 3-4 treatment-related adverse events, with no treatment-related deaths.
Although immune checkpoint inhibitors and anti-EGFR targeted therapy demonstrate preliminary antitumor activity in advanced penile cancer, their clinical efficacy remains suboptimal with substantial toxicities, thus warranting the development of more effective combinatorial therapeutic strategies.
研究概览
地位
条件
详细说明
This trial will evaluate the efficacy and safety of Becotatug Vedotin (recombinant humanized anti-EGFR mAb-MMAE conjugate) combined with Pucotenlimab (recombinant humanized anti-PD-1 mAb) as first-line therapy in the treatment of EGFR-Positive advanced penile cancer in patients who are intolerant to chemotherapy or have failed chemotherapy. Becotatug Vedotin (2.3 mg/kg, IV, Q3W) and Pucotenlimab (200 mg, IV, Q3W) will be administrated on enrolled patients. Treatment continues until disease progression, intolerable toxicity, withdrawal, death, or sponsor termination. After treatment completion, all patients will undergo survival follow-up every 3 months until death, loss to follow-up, consent withdrawal, or study termination by the sponsor.
研究类型
注册 (估计的)
阶段
- 阶段2
联系人和位置
学习联系方式
- 姓名:Hengchuan Su
- 电话号码:021-6417 5590
- 邮箱:suhengchuan@163.com
学习地点
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Shanghai、中国
- 招聘中
- Fudan University Shanghai Cancer Center
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接触:
- Su
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接触:
- SU, MD
- 电话号码:86-021-64175590
- 邮箱:suhengchuan@163.com
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参与标准
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Age ≥ 18 years.
- Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 0-1.
- Histologically confirmed penile squamous cell carcinoma with evidence of metastasis, and EGFR expression confirmed positive by immunohistochemistry (IHC).
- At least one measurable lesion per Response Evaluation Criteria in Solid Tumors (RECIST): non-lymph node lesions with a longest diameter ≥ 10 mm on computed tomography (CT) scan, or lymph node lesions with a short axis diameter ≥ 15 mm on CT scan; or evaluable cutaneous lesions per World Health Organization (WHO) criteria.
- Have received at least one prior line of chemotherapy, or be deemed chemotherapy-intolerant by the investigator.
- Adequate organ and bone marrow function, as defined by the following laboratory criteria within the screening period:
1)Hemoglobin > 8.5 g/dL, without blood transfusion or erythropoietin administration within the preceding 14 days; 2)Absolute neutrophil count (ANC) ≥ 1.5 × 10⁹/L, without granulocyte colony-stimulating factor administration within the preceding 14 days; 3)Platelet count (PLT) ≥ 90 × 10⁹/L, without blood transfusion within the preceding 14 days; 4)Total bilirubin (TBIL) ≤ 1.5 × upper limit of normal (ULN) (for patients with Gilbert's syndrome, ≤ 3 × ULN is permitted); 5)Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN (if liver metastasis is present, ALT and AST ≤ 5 × ULN is permitted); 6)Serum creatinine (Cr) ≤ 1.5 × ULN, or creatinine clearance ≥ 50 mL/min (calculated by the Cockcroft-Gault formula); 7)Adequate coagulation function, defined as international normalized ratio (INR) or prothrombin time (PT) ≤ 1.5 × ULN; 8)Normal thyroid function, defined as thyroid-stimulating hormone (TSH) within the normal range; subjects with an abnormal baseline TSH but normal total T3 (or FT3) and FT4 levels are also eligible.
7.Expected survival of more than 3 months.
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Exclusion Criteria:
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Diagnosis of another malignancy within 5 years prior to the first dose (excluding radically treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin, and/or radically resected carcinoma in situ).
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Prior treatment with an ADC drug containing monomethyl auristatin E (MMAE) as the cytotoxic moiety, or prior treatment with a PD-(L)1 inhibitor.
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Currently participating in an interventional clinical study, or having received other investigational agents or investigational device therapy within 4 weeks prior to the first dose.
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History of active autoimmune disease requiring systemic therapy (e.g., disease-modifying agents, corticosteroids, or immunosuppressants) within 2 years prior to the first dose. Replacement therapies (e.g., thyroid hormone, insulin, or physiological glucocorticoids for adrenal or pituitary insufficiency) are not considered systemic therapy.
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Major surgical procedure (excluding biopsy-only procedures) within 4 weeks prior to the first dose of study drug, or anticipated major surgery during the study period.
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Hereditary bleeding tendency, coagulation disorder, or history of thrombosis.
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History of allogeneic organ transplantation (except corneal transplantation) or allogeneic hematopoietic stem cell transplantation.
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Known hypersensitivity to the active ingredients or excipients of the study drugs vibecotamab and putelimab.
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Inadequate recovery from toxicity and/or complications caused by any prior intervention (i.e., ≤ Grade 1 or baseline levels, excluding fatigue or alopecia) before starting treatment.
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Known history of human immunodeficiency virus (HIV) infection (i.e., positive HIV 1/2 antibody).
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Untreated active hepatitis B (defined as positive HBsAg plus HBV-DNA copy number above the upper limit of normal of the local laboratory).
*Note: Subjects with hepatitis B meeting the following criteria are eligible: HBV viral load < 1000 copies/mL (200 IU/mL) before the first dose; subjects must receive anti-HBV therapy throughout the study treatment period to prevent viral reactivation.
For subjects who are anti-HBc(+), HBsAg(-), anti-HBs(-), and HBV viral load(-), prophylactic anti-HBV therapy is not required, but close monitoring for viral reactivation is necessary.
Subjects with active HCV infection (positive HCV antibody and HCV-RNA level above the lower limit of detection).*
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Administration of a live vaccine within 30 days prior to the first dose (Cycle 1, Day 1).
Note: Administration of inactivated seasonal influenza vaccine via injection within 30 days prior to the first dose is permitted; however, intranasal live attenuated influenza vaccine is not allowed.
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Presence of any severe or uncontrolled systemic disease, such as:
1)Clinically significant and symptomatic uncontrolled abnormalities in cardiac rhythm, conduction, or morphology on resting electrocardiogram (ECG), e.g., complete left bundle branch block, second-degree or higher atrioventricular block, ventricular arrhythmia, or atrial fibrillation; 2)Unstable angina pectoris, congestive heart failure, chronic heart failure of New York Heart Association (NYHA) class ≥ 2; 3)Uncontrolled hypertension (systolic blood pressure > 160 mmHg, diastolic blood pressure > 100 mmHg); 4)Active pulmonary tuberculosis; 6)Active or uncontrolled infection requiring systemic therapy; 7)Clinically active diverticulitis, abdominal abscess, or gastrointestinal obstruction; 8)Liver disease such as cirrhosis, decompensated liver disease, acute or chronic active hepatitis; 9)Uncontrolled diabetes mellitus (fasting blood glucose (FBG) > 10 mmol/L); 10)Urine routine test showing urine protein ≥ ++, confirmed 24-hour urinary protein quantification > 1.0 g; 14.Psychiatric disorders that prevent compliance with study treatment; Any other medical history, evidence of disease, treatment, or abnormal laboratory value that could interfere with study results, prevent the subject from completing the study, or for which the investigator considers the subject to be otherwise ineligible or at potential risk for participation.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:Becotatug Vedotin 联合 Pucotenlimab
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Becotatug Vedotin (recombinant humanized anti-EGFR mAb-MMAE conjugate) combined with Pucotenlimab (recombinant humanized anti-PD-1 mAb) |
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
|---|---|
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客观缓解率(ORR)
大体时间:12周
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12周
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次要结果测量
结果测量 |
大体时间 |
|---|---|
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无进展生存期
大体时间:12周
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12周
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总生存期(OS)
大体时间:12周
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12周
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疾病控制率(DCR)
大体时间:12周
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12周
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合作者和调查者
合作者
调查人员
- 首席研究员:Dingwei Ye、Fudan University
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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