This study is a multicenter, randomized, open-label, parallel-control Phase III clinical trial enrolling patients with unresectable HER2-negative, EGFR-positive recurrent/metastatic breast cancer who have previously failed first- or second-line chemotherapy. It aims to compare the efficacy and safety of SYS6010 monotherapy versus investigator-selected chemotherapy.The study plans to enroll approximately 400 subjects, randomly assigned in a 1:1 ratio to the treatment arm and control arm(Investigator's choice of standard chemotherapy regimen, including eribulin, capecitabine, gemcitabine, or vinorelbine).
This is a randomized, open-label, multicenter study designed to evaluate the efficacy and safety of SYS6010 injection versus investigator's choice of standard chemotherapy in patients with unresectable locally advanced or metastatic breast cancer that is HER2-negative with centrally confirmed EGFR expression, who have received at least one but no more than two prior lines of systemic chemotherapy for advanced or metastatic disease. Approximately 400 patients will be enrolled and randomized in a 1:1 ratio to receive either SYS6010 injection or investigator's choice of chemotherapy. Patients randomized to the experimental arm will receive SYS6010 injection。 Patients randomized to the control arm will receive investigator's choice of standard chemotherapy, which may include eribulin, capecitabine, gemcitabine, or vinorelbine, administered per local label and institutional standard practice. This study aims to determine whether SYS6010 provides clinically meaningful improvement in PFS compared with standard chemotherapy in patients with HER2-negative, EGFR-expressing advanced breast cancer. The primary endpoint is progression-free survival (PFS) assessed by a blinded independent central review (BICR) per RECIST v1.1. Secondary endpoints include overall survival (OS), investigator-assessed PFS, objective response rate (ORR), clinical benefit rate (CBR), disease control rate (DCR), duration of response (DoR), safety and tolerability, quality of life, pharmacokinetics, and immunogenicity.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
400
SYS6010, intravenous infusion
eribulin 1.4 mg/m² Intravenous infusion Administered on Day 1 and Day 8, Q3W Capecitabine 1000-1250 mg/m² orally Twice daily, Days 1-14, Q3W Gemcitabine 1000 mg/m² Intravenous infusion Administered on Days 1 and 8, Q3W Vinorelbine 25 mg/m² Intravenous infusion Administered on Day 1 and Day 8, Q3W
PFS
PFS(progression free survival) assessed by BICR based on RECIST v1.1 criteria
Time frame: Randomization up to approximately 36 months
OS (overall survival)
Overall survival is defined as the time from randomization to death from any cause.
Time frame: Randomization up to approximately 60 months
Progression-Free Survival (PFS) Assessed by Investigator
Progression-free survival assessed by the investigator is defined as the time from randomization to the first documented disease progression or death from any cause, whichever occurs first, according to RECIST version 1.1.
Time frame: Randomization up to approximately 36 months
Objective Response Rate (ORR)
Objective response rate is defined as the proportion of patients achieving a confirmed complete response (CR) or partial response (PR) according to RECIST version 1.1, as assessed by both BICR and the investigator.
Time frame: Randomization up to approximately 36 months.
Disease Control Rate (DCR)
Disease control rate is defined as the proportion of patients achieving complete response (CR), partial response (PR), or stable disease (SD) according to RECIST version 1.1, as assessed by both BICR and the investigato.
Time frame: Randomization up to approximately 36 months.
Duration of Response (DoR)
Duration of response is defined as the time from the first documented evidence of complete response (CR) or partial response (PR) until the first documented disease progression or death from any cause, whichever occurs first, according to RECIST version 1.1, as assessed by both BICR and the investigator.
Time frame: Randomization up to approximately 36 months
Mean change from baseline in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)
Health-related quality of life will be assessed using the EORTC QLQ-C30 according to the Scoring Manual. The EORTC QLQ-C30 consists of functional scales, symptom scales, and a Global Health Status/Quality of Life scale, with scores linearly transformed to a 0 to 100 scale. For functional scales and the Global Health Status/Quality of Life scale, higher scores indicate better functioning or quality of life. For symptom scales, higher scores indicate greater symptom burden. The outcome measure is the change from baseline in the selected QLQ-C30 scale scores at post-baseline assessments.
Time frame: Randomization up to approximately 36 months
Mean change from baseline in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module 42 (EORTC QLQ-BR42)
Breast cancer-specific quality of life will be assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module (EORTC QLQ-BR42), a supplementary module to the EORTC QLQ-C30, scored according to the EORTC QLQ-BR42 Scoring Manual. Scores for each scale are linearly transformed to a 0 to 100 scale. For functional scales, higher scores indicate better functioning; for symptom scales, higher scores indicate greater symptom burden. The outcome measure is the change from baseline in each BR42 scale score at post-baseline assessments.
Time frame: Randomization up to approximately 36 months
AEs and SAEs
Incidence and severity of AEs and SAEs (per CTCAE 5.0), and clinically significant abnormal laboratory findings.
Time frame: From first dose of study treatment until 30 days after the last dose.
Maximum Observed Plasma Concentration (Cmax) of SYS6010
The maximum observed plasma concentration (Cmax) of SYS6010 will be determined based on measured plasma concentrations following study drug administration, using standard non-compartmental pharmacokinetic analysis methods.
Time frame: Up to approximately 168 hours after the first dose of SYS6010.
Area Under the Plasma Concentration-Time Curve (AUC) of SYS6010
The area under the plasma concentration-time curve (AUC) of SYS6010 will be calculated based on measured plasma concentration-time data following study drug administration, using non-compartmental pharmacokinetic analysis.
Time frame: From the first dose up to approximately 168 hours post-dose.
Number of Participants With Anti-Drug Antibodies (ADAs) to SYS6010
Immunogenicity will be assessed by the incidence of anti-drug antibodies (ADAs) to SYS6010. Based on blood samples collected at predefined time points during the study.
Time frame: From baseline (prior to first dose) up to approximately 30 days after the last dose of SYS6010.
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