ZW25 in Subjects with Advanced or Metastatic HER2-Amplified Biliary Tract Cancer

  • Research type

    Research Study

  • Full title

    A Phase 2b, open-label, single-arm study of ZW25 monotherapy in subjects with advanced or metastatic HER2-amplified biliary tract cancers

  • IRAS ID

    1003020

  • Contact name

    Roopinder Gillmore

  • Contact email

    r.gillmore@nhs.net

  • Eudract number

    2020-000459-11

  • Research summary

    The proposed study is a multicentre, open-label, single-arm trial to evaluate the antitumour
    activity of ZW25 monotherapy in subjects with HER2-amplified (Human
    epidermal growth factor receptor 2), inoperable and advanced or metastatic biliary tract
    cancer, including intra-hepatic cholangiocarcinoma, extra-hepatic cholangiocarcinoma,
    and gallbladder cancer.
    Biliary tract cancers poor prognosis cancers that account for approximately 3% of all
    adult cancers. The outlook for patients with advance biliary tract cancer is very poor,
    with an estimated 5-year survival rate of approximately 5 to 15% for all patients.
    Current first line standard of care is Gemcitabine / Cisplatin (combination
    chemotherapy) but if unsuccessful, other treatment options are is limited, and can cause
    higher rate of adverse events and toxicities.
    The objective of Zymeworks’ proposed study, ZWI-ZW25-203, is to evaluate the antitumour
    activity of ZW25 single treatment in subjects with advanced or metastatic HER2-
    amplified biliary tract cancers. HER2 is short for human epidermal growth factor
    receptor 2. HER2 is a gene. Some cancers have extra copies of HER2 that can cause the
    cancer cells to grow and form a tumour. This is known as HER2-expressing cancer.
    ZW25 is a new, artificial antibody that binds to two different areas of the HER2 receptor.
    This results in a block of pathways, growth and activation of antibody-dependent cellular
    cytotoxicity.
    Two cohorts of subjects will be enrolled:
    • Cohort 1, comprising approximately 75 subjects with HER2 amplification by ISH and
    HER2 overexpression by IHC; i.e., IHC 2+ or 3+
    • Cohort 2, comprising approximately 25 subjects with HER2 amplification by ISH and
    HER2 IHC 0 or 1+
    Enrolled subjects will receive 20 mg/kg given intravenously of ZW25 every 2 weeks on
    Days 1 and 15 of each 28-day cycle until treatment discontinuation.
    Study procedures include, blood tests, CT / MRI, ECHO/MUGA, Physical examinations,
    tumour biopsies.

  • REC name

    London - Hampstead Research Ethics Committee

  • REC reference

    20/LO/0906

  • Date of REC Opinion

    26 Aug 2020

  • REC opinion

    Further Information Favourable Opinion