The Efficacy and Safety of Trastuzumab Rezetecan (SHR-A1811) in HER2-Low Unresectable/Metastatic Breast Cancer Patients With Visceral Crisis

NCT07203729 | Recruiting Phase 2 DMC

• 1 other identifier: MA-BC-II-117
• Study Type: interventional
• Target: 184
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to learn if Trastuzumab Rezetecan (SHR-A1811) is safe and tolerable for patients with HER2-Low unresectable/metastatic breast cancer complicated with visceral crisis. Participants will take Trastuzumab Rezetecan every three weeks, until disease progression or intolerable toxicity.

Conditions

HER2-Low Unresectable/Metastatic Breast Cancer Complicated With Visceral Crisis

Keywords

HER2-Low unresectable/metastatic breast cancer; Visceral Crisis; Antibody drug conjugates; Trastuzumab Rezetecan

Outcome Measures

Primary Outcomes (1)

• Progression-Free Survival (PFS)

  Progression-Free Survival is defined as the time from randomization to first documented disease progression (PD) using Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) or death from any cause, whichever occurred first. The PFS will be will be estimated using Kaplan-Meier method. A Kaplan-Meier curve, median PFS, hazard ratio with appropriate confidence intervals will be reported.

  From the start of treatment to 36 month

Secondary Outcomes (4)

• Clinical Benefit Response (CBR)

  From the start of treatment to 36 month

• Objective Overall Response Rate (ORR)

  From the start of treatment to 36 month

• Overall Survival (OS)

  From the start of treatment to 36 month

• Adverse events (AEs)

  From the start of treatment to 36 month

Study Arms (2)

Arm 1：Trastuzumab Rezetecan

EXPERIMENTAL

Drug: Trastuzumab Rezetecan

Arm 2：Chemotherapy of Physician's Choice

ACTIVE COMPARATOR

Drug: Chemotherapy of Physician's Choice

Interventions

Trastuzumab Rezetecan DRUG

Trastuzumab Rezetecan 4.8mg/kg, IV, Day 1, Q3W

Arm 1：Trastuzumab Rezetecan

Chemotherapy of Physician's Choice DRUG

Chemotherapy of Physician's Choice, including nab-paclitaxel, Eribulin, Capecitabine, Vinorelbine, Gemcitabine.

Also known as: nab-paclitaxel, Eribulin, Capecitabine, Vinorelbine, Gemcitabine

Arm 2：Chemotherapy of Physician's Choice

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age: ≥18 years old and ≤75 years old;
• Pathologically confirmed HER2-Low unresectable or metastatic breast cancer;
• Visceral crisis is defined as severe organ dysfunction as assessed by signs, symptoms and laboratory studies, resulting from rapid progression of neoplastic disease and indicative of substantial visceral compromise that may serve as an indication for more aggressive therapeutic intervention, including：a）Liver visceral crisis: rapidly increasing bilirubin \>1.5 × ULN in the absence of Gilbert's syndrome or biliary tract obstruction；b）Lung visceral crisis: rapidly increasing dyspnoea at rest, not alleviated by drainage of pleural effusion；c）Other visceral crises: the evaluation is conducted by the clinician based on the definition of visceral crisis specified in the ABC7 guideline.
• Patients whom investigators deem to have indications for single-agent chemotherapy.
• Sufficient bone marrow function, defined as follows：a) Neutrophil count (ANC) ≥ 1,500/mm³ (1.5 × 10⁹/L)；b) Platelet count (PLT) ≥ 80 ×10\^9/L；c) Hemoglobin (Hb) ≥ 80 g/L；
• Patients who have received ≤ 1 line of chemotherapy in the advanced stage are permitted.
• Patients who have received endocrine therapy in the advanced stage are permitted.
• Previous treatment with CDK4/6 inhibitors is permitted.
• Previous or concurrent local treatment for symptom relief is permitted.
• For female subjects who are premenopausal or not surgically sterilized:
• A serum pregnancy test must be performed within 7 days before the first dose of study drug, with a negative result. They must agree to either abstain from sexual activity or use a medically approved highly effective contraceptive method from the time of signing the informed consent form, throughout the study period, and for 1 year after the last dose of study drug.
• Patients must voluntarily participate in this study, sign the informed consent form, have good compliance, and be willing to cooperate with follow-up.

You may not qualify if:

• Have received treatment with new antibody-drug conjugates (ADCs) at any stage of breast cancer.
• Are deemed by the investigator as unsuitable for systemic chemotherapy.
• Have had other malignant tumors within the past 5 years, excluding cured carcinoma in situ of the cervix, cutaneous basal cell carcinoma, or cutaneous squamous cell carcinoma (patients with other malignant tumors that occurred more than 5 years before randomization and were cured solely by surgery are eligible for enrollment).
• Have undergone major surgical procedures or suffered significant trauma within 4 weeks prior to randomization, or are expected to undergo major surgical treatment.
• Have severe heart disease or cardiac discomfort, including but not limited to the following conditions：a) A history of heart failure or systolic dysfunction (left ventricular ejection fraction \[LVEF\] \< 50%)；b) High-risk angina pectoris requiring treatment or cardiac arrhythmias；c) Clinically significant valvular heart disease；d) ECG findings indicating transmural myocardial infarction；e) Poorly controlled hypertension.
• Have a known history of allergy to any component of the drugs in this protocol.
• Have a history of immunodeficiency, including HIV infection, or other acquired or congenital immunodeficiency diseases.
• Have a known history of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation.
• Have a known history of psychotropic substance abuse or drug addiction.
• Are pregnant or lactating women, or women of childbearing age who are unwilling to use effective contraceptive measures throughout the trial period and within 7 months after the last administration of the study drug.
• Have severe diseases, other comorbidities that would interfere with the planned treatment, or any other conditions that make them unsuitable for participation in this study (e.g., active hepatitis B, pulmonary infection requiring treatment).

Sponsors & Collaborators

• Cancer Institute and Hospital, Chinese Academy of Medical Sciences: lead

Study Sites (1)

Cancer Hospital, Chinese Academy of Medical Sciences

Beijing, Beijing Municipality, 100021, China

RECRUITING

MeSH Terms

Conditions

Breast Neoplasms

Interventions

130-nm albumin-bound paclitaxel; eribulin; Capecitabine; Vinorelbine; Gemcitabine

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Deoxycytidine; Cytidine; Pyrimidine Nucleosides; Pyrimidines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Fluorouracil; Uracil; Pyrimidinones; Deoxyribonucleosides; Nucleosides; Nucleic Acids, Nucleotides, and Nucleosides; Vinca Alkaloids; Secologanin Tryptamine Alkaloids; Indole Alkaloids; Alkaloids; Indoles; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Indolizidines; Indolizines

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Chief Physician

Study Record Dates

• First Submitted: September 25, 2025
• First Posted: October 2, 2025
• Study Start: March 1, 2026
• Primary Completion (Estimated): June 15, 2030
• Study Completion (Estimated): December 30, 2030
• Last Updated: March 16, 2026

Record last verified: 2026-03

Locations

CN (1)