The study consists of two phases. Phase 1b and Phase 2. Phase 1b aims to evaluate the safety, tolerability, and preliminary efficacy of SYS6010 as a monotherapy and in combination with SYH2051, and to determine the recommended Phase 2 dose (RP2D) for subsequent Phase 2 studies. Phase 2 aims to assess the efficacy and safety of SYS6010 monotherapy or in combination with SYH2051 compared to investigator-selected chemotherapy in patients with EGFR-expressing, unresectable locally advanced or metastatic advanced breast cancer.
Phase Ⅰb Design: Group A (SYS6010 3.2 mg/kg, Q2W): Monotherapy Cohort: Planned enrollment of 8-12 breast cancer patients to evaluate the safety and preliminary efficacy of SYS6010 monotherapy. Combination Cohort: Includes dose-escalation and expansion phases. Dose-escalation phase: A "3+3" design will be used to explore the safety of SYS6010 combined with SYH2051, with SYH2051 doses ranging from 60-80 mg. Expansion phase: Upon completion of dose-escalation and confirmation of safety, breast cancer patients may be enrolled in the expansion phase. Group B (SYS6010 3.6 mg/kg, Q2W): Monotherapy Cohort: Planned enrollment of 8-12 breast cancer patients. Combination Cohort: Similar to Group A, with SYH2051 doses ranging from 40-60 mg. Group C (SYS6010 3.6 mg/kg, Q2W): Enroll 40 EGFR-expressing HR+/HER2- breast cancer patients to further evaluate the safety and efficacy in this specific population. Phase Ⅱ Design: Based on molecular subtypes of breast cancer, cohort studies will be conducted. Each cohort will enroll 125 patients, randomized in a 2:2:1 ratio into three groups: SYS6010 + SYH2051 SYS6010 monotherapy Chemotherapy control.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
410
SYS6010 is an antibody conjugate drug (ADC), composed of one anti-EGFR monoclonal antibody coupled to one JS1 via an enzyme specific linker
Investigator's choice of monotherapy chemotherapy (Eribulin, Capecitabine, Gemcitabine, Vinorelbine, or Taxanes.)
SYH2051 is a Selective ATM protein kinase inhibitor
Dose-limiting toxicity(DLT) occurrence and incidence
The occurrence and incidence of dose-limiting toxicities (DLTs) will be assessed based on predefined criteria during the first 28 days after the initial dose. DLTs are defined as adverse events related to the study drug that meet the protocol-specified criteria for dose limitation.
Time frame: Up to approximately 3 months after the first participant is enrolled
Adverse events (AE) occurrence and incidence
The occurrence and incidence of adverse events (AEs) will be evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0. AEs will be monitored from the first dose until the safety follow-up period.
Time frame: Up to approximately 36 months after the first participant is enrolled
Objective response rate (ORR) per RECIST v1.1
The objective response rate (ORR) will be assessed based on RECIST v1.1 criteria. ORR is defined as the proportion of patients achieving a complete response (CR) or partial response (PR) as the best overall response.
Time frame: Up to approximately 36 months after the first participant is enrolled
Disease control rate (DCR) per RECIST 1.1
Time frame: Up to approximately 36 months after the first participant is enrolled
Duration of response (DoR) per RECIST 1.1
Time frame: Up to approximately 36 months after the first participant is enrolled
Progression free survival (PFS) per RECIST 1.1
Time frame: Up to approximately 36 months after the first participant is enrolled
Overall survival(OS)
Time frame: Up to approximately 36 months after the first participant is enrolled
PK parameters of toxin-bound antibody
Time frame: Up to approximately 36 months after the first participant is enrolled
Description :total antibody and free toxin (JS-1) after single and continuous administration of SYS6010
Time frame: Up to approximately 36 months after the first participant is enrolled
PK parameters after single and multiple administrations of SYH2051
Time frame: Up to approximately 36 months after the first participant is enrolled
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