In this study, 60 patients with HER2 overexpression UTUC with high-risk recurrence factors after radical surgery were proposed to be enrolled, and were assigned to Cohort I (receiving adjuvant therapy group) and Cohort II (refusing to receive adjuvant therapy group) according to the subjects' wishes. Cohort I subjects were treated with vedicloxacinumab in combination with radiotherapy, and vedicloxacinumab treatment lasted for 6 months. Cohort II subjects receive close observation and best supportive care. Safety evaluations and efficacy evaluations will be performed during the study period. Safety Evaluations: Safety evaluations will be conducted within 3 days prior to each dose and will continue until 30 days after the last study dose or initiation of new antitumor therapy for subjects who have received at least one dose of study drug. Evaluation of effectiveness: effectiveness evaluations will be conducted every 12 weeks (±3 days) until imaging-confirmed tumor recurrence, subject death, withdrawal of informed consent, loss to follow-up, or study termination, whichever occurs first. Tumor assessment was performed according to the Criteria for Evaluation of Efficacy in Solid Tumors (RECIST v1.1). For subjects with disease progression, postoperative tumor recurrence, or initiation of other antitumor therapy, survival follow-up was performed every 3 months (window period ± 14 days) from the date of notification to collect information on the subject's subsequent antitumor therapy and survival until the subject's death, withdrawal of informed consent, loss of visit, or study termination, whichever occurred first.
Voluntary enrollment and signing of written informed consent;
Age ≥ 18 years, male or female;
Pathologically confirmed UTUC with at least any one of the following conditions: ① pT2 (need to be combined with at least simultaneous G3/high-grade tumor multiple, multifocal positive margins and one of the high-risk recurrence factors); ② pT3 to pT4; ③ pN+;
Cisplatin intolerance or not receiving platinum-based drugs for adjuvant therapy;
A history of malignancy other than uroepithelial carcinoma, except in the following two cases: a) The patient has received potentially curative therapy and has had no evidence of the disease for 5 years; b) Basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial bladder cancer, carcinoma in situ of the uterine cervix, and other carcinomas in situ for which resection was successfully received;
Prior allogeneic stem cell or parenchymal organ transplantation;
Patients who have received other prior anti-tumor systemic therapy (including herbal medicine with anti-tumor indications) less than 4 weeks after completion of therapy and prior to dosing in this study, or who have not recovered from adverse events caused by prior therapy to ≤ CTCAE grade 1 (with the exception of alopecia and hyperpigmentation);
Prior or current congenital or acquired immunodeficiency disease;
Parallel
Disitamab Vedotin
DrugDisitamab vedotin (RC48-ADC) is a novel humanized anti-human epidermal growth factor receptor 2 (HER2) antibody conjugated with monomethyl auristatin E via a cleavable linker. Two phase II studies, RC48-C005 (NCT03507166) and RC48-C009 (NCT03809013), have shown its significant antitumor potential in patients with la/mUC with HER2 overexpression (immunohistochemistry (IHC) 3+ or 2+). In 2022, RC48-ADC was approved for patients with HER2 overexpressing la/mUC who had received prior chemotherapy in China.
Radiotherapy
RadiationRadiotherapy dose: 45-50 Gy/25f/5w to lymph node drainage area; 62.5 Gy/25f/5w to metastatic or suspected metastatic lymph nodes.
Standard of Care
Other interventionStandard of Care
Disease Free Survival (DFS)
Overall Survival (OS)
Metastasis-Free Survival (MFS)
Local-Recurrence Free (LRF)
Over-time Changes in ECOG PS scores
Ecog PS score Eastern Cooperative Oncology Group (ECOG) Performance Status: the minimum value is 0 and maximum value is 4. Higher scores mean a worse outcome.
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