An Open-label, Single-arm, Multicenter Phase II Clinical Study to Evaluate Neoadjuvant Gemcitabine Combined With Trastuzumab Rezetecan in HER2-positive Upper Tract Urothelial Carcinoma
Condition: UTUC
Study Type: Interventional
Clinical Trials Identifier NCT 8-digits: NCT07741448
Sponsor: Zhiquan Hu
Phase: Phase 2
Eligibility:
- Age: minimum 18 Years maximum 75 Years
- Gender: All
Inclusion Criteria:
- 1. The subject voluntarily participates in the study, provides written informed consent, and is able to comply with study procedures and follow-up visits. 2. Aged between 18 and 75 years. 3. Patients diagnosed with upper tract urothelial carcinoma (UTUC) who are candidates for radical nephroureterectomy with bladder cuff excision. 4. Clinical stage T1N0M0
- T2-T4aN1M0 (evaluated by CT/MRI/PET-CT). 5. Histopathology confirms urothelial carcinoma as the predominant component; IHC testing shows HER2 expression of 2+ to 3+. 6. ECOG performance status ≤ 2. 7. Laboratory parameters meet all of the following criteria:
- Absolute neutrophil count ≥ 1.5 × 10⁹/L
- Platelets ≥ 100 × 10⁹/L; hemoglobin ≥ 90 g/L
- Total bilirubin ≤ 1.5 × ULN
- Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) ≤ 2.5 × ULN; serum creatinine ≤ 3 × ULN 8. Cardiac function: New York Heart Association (NYHA) classification < Grade III.
Exclusion Criteria:
- Received live attenuated vaccines within 4 weeks prior to enrollment or plan to receive such vaccines during the study.
- Received systemic chemotherapy, anti-PD-1/PD-L1 agents, or HER2-targeted therapy within the previous 6 months.
- Known hypersensitivity to gemcitabine, Trastuzumab Rezetecan, or any of their excipients.
- Active, known or suspected autoimmune disease.
- Known history of primary immunodeficiency.
- Known history of solid organ allotransplantation or allogeneic hematopoietic stem cell transplantation.
- Female patients who are pregnant or breastfeeding.
- Untreated acute or chronically active hepatitis B or hepatitis C infection. Patients receiving antiviral therapy may be considered eligible at the investigator's discretion with ongoing viral load monitoring.
- Uncontrolled concurrent illnesses, including but not limited to:
- HIV infection (positive HIV antibody).
- Severe active infection with inadequate clinical control.
- Evidence of severe or uncontrolled systemic disease (e.g., severe psychiatric or neurological disorders, epilepsy or dementia; unstable or decompensated respiratory, cardiovascular, hepatic or renal disease; uncontrolled hypertension defined as CTCAE Grade ≥2 hypertension despite medical treatment).
- Active bleeding, newly diagnosed thromboembolic disease requiring therapeutic anticoagulation, or bleeding diathesis.
- Diagnosis of another malignant tumor within the past 5 years.
- Active tuberculosis
View trial on ClinicalTrials.gov