EGFR-ADC (Becotatug Vedotin) Combined With PD-1 Inhibitor (Pucotenlimab) in Neoadjuvant Treatment of Advanced Penile Cancer

ConditionPenile Cancer
Trial statusRecruiting
Trial phasePhase 2
Trial typeInterventional
Biological sexMale
Age18+
SponsorJiyan Liu

About this trial

This clinical study is a Phase II research trial focused on a new preoperative treatment for men with advanced penile squamous cell carcinoma (a type of penile cancer). The cancer may be hard to treat with penile-sparing surgery, or it may have spread to nearby lymph nodes (like groin lymph nodes).

We are testing a combination of two medicines: Becotatug vedotin (a targeted therapy that finds and kills cancer cells with high levels of a protein called EGFR) and Pucotenlimab (an immunotherapy that helps your body's immune system fight cancer). The goal is to see if this combination can shrink the tumor, make surgery more likely to remove all cancer cells, and improve treatment outcomes-while keeping side effects manageable.

Who can join?

To be eligible, you must:

Be a man 18 years or older with confirmed penile squamous cell carcinoma; Have cancer that is hard to treat with penile-sparing surgery or has spread to regional lymph nodes; Have cancer cells that test positive for EGFR (a protein most penile cancers make); Have not received prior systemic cancer treatment (or had recurrence more than 6 months after adjuvant therapy for radical resection); Have adequate organ function (e.g., healthy heart, liver, and kidney function) to tolerate treatment; Understand the study and voluntarily agree to participate by signing an informed consent form.

What will happen during the study? Screening (up to 28 days): You will have tests to confirm eligibility, including imaging scans, blood work, and EGFR testing on your tumor sample.

Preoperative treatment (4-6 cycles): You will receive intravenous infusions of Becotatug vedotin (2.0 mg/kg) and Pucotenlimab (200 mg) every 3 weeks. Every 6 weeks, you will have imaging scans to check if the tumor is shrinking.

Surgery: If the tumor responds to treatment (assessed by a team of doctors), you will undergo radical surgery to remove the cancer. If surgery is successful, you may continue Pucotenlimab as adjuvant therapy for 1 year.

Follow-up: After treatment, you will be checked every 3 months for 2 years to monitor for cancer recurrence and long-term side effects.

What are the study goals? Primary goal: To find out how many patients can have successful surgery to remove all visible cancer (R0 resection) after the combination treatment.

Secondary goals: To measure how much the tumor shrinks (objective response rate), if the cancer stage improves (downstaging rate), if surgery removes all cancer cells (pathological complete response rate), how long patients stay cancer-free (disease-free survival), and how safe the treatment is.

What are the potential risks? As with any cancer treatment, this combination may cause side effects. Common expected side effects include skin reactions (e.g., rash), digestive issues, changes in blood cell counts, liver function changes, and immune-related reactions (e.g., thyroid problems, lung inflammation). These side effects will be closely monitored by the study team, and treatments to manage them will be provided.

This study is being conducted at West China Hospital, Sichuan University. It is a single-arm trial (all participants receive the same combination treatment) and will enroll about 60 patients. The study is expected to run from April 2026 to April 2028.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Left ventricular ejection fraction (LVEF) ≥50%;

Hemoglobin (HGB) ≥90 g/L, white blood cell (WBC) ≥3.0×10⁹/L, absolute neutrophil count (ANC) ≥1.5×10⁹/L, platelet (PLT) ≥80×10⁹/L;

Total bilirubin (TBIL) ≤1.5×ULN, AST/ALT ≤2.5×ULN (≤5×ULN for liver metastasis), serum creatinine (Cr) ≤1.5×ULN or creatinine clearance (CrCl) ≥50 mL/min; (8)Voluntarily participate, understand the study, and sign informed consent form.

Disqualifiers

None

Trial design

Design model

Single group

Treatments tested in this trial

  • Becotatug Vedotin

    Drug

    Becotatug vedotin is an EGFR-targeted antibody-drug conjugate (ADC) composed of a high-affinity anti-EGFR monoclonal antibody conjugated to monomethyl auristatin E (MMAE) via a cleavable valine-citrulline linker. In this phase II neoadjuvant trial, it is administered intravenously at a dose of 2.0 mg/kg once every 3 weeks for 4-6 cycles, in combination with Pucotenlimab, for patients with EGFR-expressing locally advanced penile squamous cell carcinoma.

  • Pucotenlimab

    Drug

    Pucotenlimab is a humanized, high-affinity anti-PD-1 monoclonal antibody that blocks PD-1/PD-L1/PD-L2 binding to reactivate antitumor immunity. In this trial, it is administered intravenously at 200 mg once every 3 weeks: 4-6 cycles as neoadjuvant therapy with Becotatug vedotin, followed by 1 year of adjuvant therapy for patients achieving R0 resection, for EGFR-expressing locally advanced penile squamous cell carcinoma.

Treatment groups

60 Participants
are divided into 1 treatment group
Group A: Becotatug Vedotin + Pucotenlimab Neoadjuvant ArmExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Surgical Resection Rate

Proportion of patients who achieve R0 resection (no residual tumor cells at margins) after neoadjuvant therapy, confirmed by surgical records and postoperative pathological reports.

Time frame
Up to 6 months after the start of neoadjuvant therapy (after completion of 4-6 cycles of treatment and MDT evaluation).

Secondary outcomes

1

Objective Response Rate (ORR)

Proportion of patients with complete response (CR) + partial response (PR) per RECIST 1.1, evaluated by imaging.

Time frame
Every 6 weeks during neoadjuvant therapy, up to 6 months.
2

Downstaging Rate

Proportion of patients with reduced tumor stage (focus on inguinal lymph node stage) after neoadjuvant therapy.

Time frame
After completion of neoadjuvant therapy (up to 6 months).
3

Pathological Complete Response (pCR) Rate

Proportion of patients with no residual viable tumor cells (0% RVT) in primary tumor and sampled lymph nodes, confirmed by central pathology.

Time frame
Within 1 month after surgery.
4

Major Pathological Response (MPR) Rate

Proportion of patients with residual viable tumor cells ≤10% in primary tumor and sampled lymph nodes, confirmed by central pathology.

Time frame
Within 1 month after surgery.

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Jiyan Liu

Lead sponsor

West China Hospital

Sponsor institution

Lepu Medical Technology (Beijing) Co., Ltd.

Collaborator