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Brief Title: PD-L1 Antibody ZKAB001(Drug Code) in Locally Advanced and Metastatic Urothelial Carcinoma

An Open-label, Dose-escalation, Bi-weekly Phase I+II Clinical Trial in Treating Patients With Locally Advanced and Metastatic Urothelial Carcinoma


  • Org Study ID: NTL-LEES-2017-01
  • Secondary ID: N/A
  • NTC ID: NCT03676946
  • Sponsor: Lee's Pharmaceutical Limited


This is a Phase 1+2, open-label, dose-escalation, and multidose study, aiming to investigate
the safety, tolerability and pharmacokinetics of ZKAB001 (a fully human monoclonal antibody
targeting the Programmed Death - Ligand 1 (PD-L1) membrane receptor on T lymphocytes and
other cells of the immune system) administered every 14 days in subjects with locally
advanced and metastatic urothelial carcinoma.


The study will consist of 4 periods: Screening (up to 28 days), Lead-in period (Day -28),
Treatment (up to 24 cycles or 1 year, whichever occurs first), and Follow-up (up to 1 year).
There will be a lead-in period on Day -28 for each dose escalation cohort in which the
single-dose pharmacokinetics(PK) of ZKAB001 will be characterized prior to initiation of
continuous dosing in the first cycle of treatment. The lead-in period duration, PK
time-points, doses and/or regimens used in subsequent cohorts may be modified based on the
exposure (AUC) observed during the lead-in period (although the number of PK samples will not
be increased). Treatment of continuous dosing is up to 24 cycles or 1 year, until as per
investigator's opinion, subjects experience disease progression (evaluated by RECIST 1.1 and
immune-related response criteria irRECIST), no clinical benefit, or intolerable toxicity. If
investigators suspect subjects experience pseudoprogression or has evidence to prove "mixed
response", subjects can continue to accept treatment as investigator decided.

  • Overall Status
  • Start Date
    October 10, 2018
  • Phase
    Phase 1/Phase 2
  • Study Type


Primary Outcome 1 - Measure: Dose limiting toxicity (DLT)

Primary Outcome 1 - Timeframe: 28 days after first dose


  • Urothelial Carcinoma


Inclusion Criteria:

1. The subject voluntarily gives written informed consent to participate in the study.

2. Female and male patients aged between 18 and 75 (inclusive).

3. Subjects must have a histologically and/or cytologically confirmed diagnosis of
urothelial carcinoma and the recurrence or metastasis is confirmed again after
recurrence, and must have failed or are intolerable to standard therapies or for whom
no standard therapies exist.

4. Must have measurable disease with at least 1 unidimensional measurable lesion
(recorded as the maximum diameter) based on RECIST 1.1.

5. Eastern Cooperative Oncology Group(ECOG) performance status of 0 or 1, with estimated
life expectancy of at least 3 months.

6. Adequate blood routine, hepatic and renal function:

1)neutrophil count (ANC) absolutely acuity≥1.5 x 109 / L; 2)platelet count≥80 x 109 / L ;
3)hemoglobin≥90 g/L; 4)serum albumin≥28 g/L; 5)bilirubin≤1.5 x ULN (upper limit of normal
); 6)ALT and AST≤1.5 x ULN, such as liver metastasis, ALT (alanine transaminase) and AST≤5
x ULN; 7)serum Cr≤1.25 x ULN or endogenous creatinine clearance≥50 ml/min (according
Cockcroft Gault formula).

7.Female patients of reproductive age should take effective contraception during the study
period and within 3 months after the study treatment period. The serum or urine human
chorionic gonadotropin (HCG) examination must be negative within 7 days before the study
was enrolled.

Exclusion Criteria:

1. Any active autoimmune disease or history of autoimmune disease (such as, but not
limited to, interstitial pneumonia, uveitis, enteritis, hepatitis, arthritis,
nephritis, pituitary inflammation, hyperthyroidism, hypothyroidism, etc.); Patients
with vitiligo or asthma in childhood, and still need medical intervention in adult;
Patients need bronchodilators for medical intervention of asthma.

2. Patients are using immunosuppressive agents, or systemic, or absorbable topical
corticosteroid medications to achieve immunosuppressive purposes (doses >10mg/day
prednisone or equivalent), which is ongoing 2 weeks before enrollment.

3. Have received any form of organ transplantation, including allogeneic stem cell

4. Known allergy to macromolecular protein inhibitors or any of the components of

5. Suffering from other malignant tumors other than this diseases in 5 years except skin
basal cell and squamous cell carcinoma or cervical carcinoma in situ.

6. Central nervous system metastases with clinical symptoms (such as cerebral edema and
brain metastases requiring corticosteroid intervention). Previous treatment with brain
or meningeal metastasis, such as clinical stabilization (MRI) less than 2 months, or
systemic corticosteroid (dose >10mg/day prednisone or equivalent) less than 2 weeks.

7. Patients with clinical symptoms or heart diseases that cannot be well controlled, such
as heart failure above New York Heart Association (NYHA) 2 grade, unstable angina
pectoris, myocardial infarction in 1 year, and clinically significant supraventricular
or ventricular arrhythmia requiring treatment or intervention, left ventricular
ejection fraction < 50% at rest as shown in the ultrasound cardiogram.

8. Patients who had received radiotherapy, chemotherapy, surgery or molecular targeted
therapy before, were given less than 4 weeks or 5 half-life (longer time) after the
treatment (if treated with nitrosourea or mitomycin previously, the time interval
between the end of chemotherapy and study inclusion was less than 6 weeks); Adverse
events caused by previous treatment did not recover to level 1 of CTCAE, except for
hair loss.

9. Active infection, or unexplained fever> 38.5 degrees during screening period or before
the first dose of ZKAB001 (subjects with fever from the tumor could be enrolled upon
investigator's decision).

10. Human immunodeficiency virus (HIV) positive, syphilis spirochete positive, untreated
active hepatitis.

11. The patient is participating in other clinical studies or is less than 1 month away
from the end of the previous clinical study.

12. Patients may need to receive other systemic cancer treatment during study period.

13. Prior therapy with an anti-PD 1, anti-PD L1, or anti-CTLA-4 (Cytotoxic T Lymphocyte
Antigen-4) antibody (or any other agents that target immunoregulatory receptor).

14. Recent history of prophylactic non-cancer vaccination (such as seasonal influenza
vaccine and human papillomavirus (HPV) vaccine) within 28 days before screening.

15. History of mental drug abuse, alcohol abuse or drug abuse.

16. Pregnant or lactating women.

17. Any mental condition that prevents the understanding or provision of an informed

18. It is determined by the investigator that the patient has other factors that may lead
to the termination of the study, such as other serious diseases or serious laboratory
test abnormalities or other factors that may affect the safety of the subjects, family
or social factors that may affect the study data and sample collection.

Gender: All

Minimum Age: 75 Years

Maximum Age: 18 Years

Healthy Volunteers: No


Name: Jun Guo, MD

Role: Study Director

Affiliation: Beijing Tumor Hospital

Overall Contact

Name: Jun Guo, MD

Phone: 010-88121122

Email: guoj307@126.com


Facility Status Contact
Facility: Beijing Tumor Hospital
Beijing, Beijing 100000
Status: Recruiting Contact:
Jun Guo, M.D