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Adenoid Cystic CarcinomaPhase 2MRG003-SACCNCT07522879

A Study of Becotatug Vedotin (MRG003) Combined With Epirubicin as Neoadjuvant Therapy for EGFR-Positive, Unresectable Recurrent Sinonasal Adenoid Cystic Carcinoma

A Phase 2 study testing Becotatug Vedotin in people with Adenoid Cystic Carcinoma and Sinonasal Carcinoma, run by Eye & ENT Hospital of Fudan University at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This prospective, multicenter clinical study aims to evaluate the efficacy and safety of neoadjuvant therapy with MRG003 (Becotatug vedotin) combined with epirubicin in patients with EGFR-positive, unresectable recurrent sinonasal adenoid cystic carcinoma (SNACC). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Adenoid Cystic Carcinoma, Sinonasal Carcinoma
What is being tested?
Becotatug Vedotin
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteChina
Study dates
28 Apr 2026to 1 Jul 2030
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years, male or female. Histopathologically confirmed sinonasal adenoid cystic carcinoma (SNACC) with measurable recurrent disease located in the sinonasal/skull base region, irrespective of the presence of regional lymph node or distant metastases.
  • EGFR expression positive by immunohistochemistry (IHC) performed at a central laboratory.
  • Multidisciplinary team (MDT) assessment at baseline confirms that the tumor is not amenable to radical (R0) surgical resection.
  • At least one measurable lesion in the skull base/sinonasal region according to RECIST v1.1 (longest diameter ≥ 10 mm).
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Adequate bone marrow, hepatic, renal, and cardiac function as defined by protocol-specified laboratory parameters.
  • Willing to provide written informed consent (including consent for clinical treatment and biospecimen research) and able to comply with study procedures.

Who cannot join

  • Prior treatment with any antibody-drug conjugate (ADC) that contains monomethyl auristatin E (MMAE) as the payload.
  • Prior systemic chemotherapy containing epirubicin or any other anthracycline within 6 months before study enrollment.
  • Active uncontrolled infection, or active autoimmune disease requiring systemic therapy.
  • Symptomatic or urgent (e.g., requiring radiotherapy or surgery) central nervous system (CNS) metastases.
  • Known severe hypersensitivity to any component of the study drugs. Pregnant or breastfeeding women, or men/women planning to become pregnant within 6 months after the last dose of study treatment.
  • Any medical or psychosocial condition that, in the investigator's judgment, may interfere with study participation, increase patient risk, or confound data interpretation.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Quan Liu, Director contact

8615001959681

liuqent@163.com

Wanpeng Li, mid-level contact

8613262856870

18879117831@163.com

China1 site, 1 recruiting
  • Eye & ENT Hospital of Fudan University

    Shanghai

    Wanpeng Li, MD, 86-13262856870, 18879117831@163.com

    Recruiting

Other trials in China

About this study

Official title: Becotatug Vedotin (MRG003) Combined With Epirubicin as Neoadjuvant Therapy for EGFR-Positive, Unresectable Recurrent Sinonasal Adenoid Cystic Carcinoma: A Prospective, Multicenter Clinical Study

This prospective, multicenter clinical study aims to evaluate the efficacy and safety of neoadjuvant therapy with MRG003 (Becotatug vedotin) combined with epirubicin in patients with EGFR-positive, unresectable recurrent sinonasal adenoid cystic carcinoma (SNACC). The primary question is whether this combination can achieve a sufficient objective response rate (ORR) to enable subsequent radical surgery or improve disease control.

Read the detailed description

This is a prospective, multicenter, single-arm, open-label phase II clinical study. Patients with histologically confirmed recurrent sinonasal adenoid cystic carcinoma (SNACC) that is deemed unresectable by a multidisciplinary team (MDT) and positive for EGFR expression (IHC) are eligible.

Intervention:

  • MRG003 (Becotatug vedotin): 2.0 mg/kg IV on day 1 of each 21-day cycle.
  • Epirubicin: 75 mg/m² IV on day 1 of each 21-day cycle.
  • Total of 3 neoadjuvant cycles.

Primary Outcome Measure: Objective response rate (ORR) according to RECIST v1.1, assessed 21 days (±7 days) after the third cycle.

Secondary Outcome Measures:

  • Safety and tolerability (CTCAE v5.0)
  • Surgical conversion rate (proportion of patients achieving R0/R1 resection after neoadjuvant therapy)
  • R0 resection rate and pathological response rate (major pathological response ≤10% viable tumor cells; pathological complete response 0%)
  • Disease control rate (DCR), progression-free survival (PFS), and overall survival (OS)

Sample Size: 40 evaluable patients. Assuming a historical ORR of 10% with single-agent epirubicin, the study is designed to detect an improvement to 35% with the combination (one-sided exact binomial test, α=0.05, power 80%). The sample size also ensures sufficient power for key secondary endpoints and supports the translational sub-study (≥28 successful organoid models).

Translational Research Component: Pre-treatment tumor biopsies will be used to establish patient-derived organoids (PDOs). Organoids will be characterized (H\&E, immunofluorescence, STR genotyping) and tested ex vivo for sensitivity to MRG003, epirubicin, and their combination. Associations between organoid drug sensitivity and clinical response (ORR, tumor shrinkage, PFS) will be explored.

Statistical Analysis: Primary analysis will be performed on the full analysis set (all treated patients). ORR and other binary endpoints will be reported with exact 95% confidence intervals (Clopper-Pearson method). PFS and OS will be estimated using Kaplan-Meier method. Translational data will be analyzed using Spearman rank correlation, Chi-square or Fisher's exact tests, and exploratory Cox regression.

Study Duration: Approximately 48 months, including 24 months enrollment, 3-6 months treatment/short-term follow-up per patient, and 24 months long-term survival follow-up after last patient enrollment.

Data Monitoring: An independent Data Safety Monitoring Board (DSMB) will conduct interim safety review after 20 patients are enrolled.

Being tested
Becotatug Vedotin
Keywords
EGFR protein, Unresectable, Adenoid cystic carcinoma, Sinonasal, Becotatug vedotin, Epirubicin, Prospective Studies
Medical subject headings
Carcinoma, Adenoid Cystic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Becotatug VedotinDrug

    Becotatug vedotin (also known as MRG003) is an antibody-drug conjugate (ADC) targeting epidermal growth factor receptor (EGFR). It consists of a recombinant anti-EGFR humanized monoclonal antibody conjugated to the microtubule-disrupting agent monomethyl auristatin E (MMAE) via a valine-citrulline linker. It is administered intravenously at 2.0 mg/kg on day 1 of each 21-day cycle for 3 cycles.

    Epirubicin is an anthracycline chemotherapeutic agent that inhibits topoisomerase II, thereby interfering with DNA replication and transcription. It is administered intravenously at 75 mg/m² on day 1 of each 21-day cycle for 3 cycles.

Study groups in NCT07522879
Study groupRoleWhat they receive
MRG003 + EpirubicinExperimentalParticipants receive MRG003 (Becotatug vedotin) 2.0 mg/kg intravenously on day 1 plus epirubicin 75 mg/m² intravenously on day 1 of each 21-day cycle for 3 cycles.
Receives: Drug: Becotatug Vedotin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Objective Response Rate (ORR)

    Proportion of participants achieving complete response (CR) or partial response (PR) as assessed by the investigator according to RECIST v1.1 criteria.

    Measured: 21 days (±7 days) after completion of the third cycle of neoadjuvant therapy (each cycle is 21 days).

Secondary outcomes (7)
  1. Safety and tolerability

    Incidence, severity, and relationship of adverse events (AEs) and serious adverse events (SAEs) graded according to CTCAE v5.0.

    Measured: From first dose of study treatment up to 30 days after last dose (approximately 4 months per participant).

  2. Surgical conversion rate

    Proportion of participants who undergo radical surgery (R0 or R1 resection) after neoadjuvant therapy, as assessed by multidisciplinary team (MDT).

    Measured: Within 4 weeks after completion of neoadjuvant therapy (i.e., approximately 3.5 months from treatment start).

  3. Disease control rate (DCR)

    Proportion of participants achieving complete response (CR), partial response (PR), or stable disease (SD) according to RECIST v1.1.

    Measured: 21 days (±7 days) after completion of the third cycle of neoadjuvant therapy.

  4. R0 resection rate

    Among participants who undergo surgery, proportion with negative microscopic margins (R0) on final histopathology.

    Measured: At time of surgery (within 4 weeks after neoadjuvant therapy completion).

  5. Pathologic response rate

    Among participants who undergo surgery, proportion achieving major pathologic response (≤10% viable tumor cells) or pathologic complete response (0% viable tumor cells).

    Measured: At time of surgery (within 4 weeks after neoadjuvant therapy completion).

  6. Progression-free survival (PFS)

    Time from enrollment to first documented disease progression (by RECIST v1.1) or death from any cause, whichever occurs first.

    Measured: Assessed every 3 months for the first 2 years, then every 6 months up to 5 years, or until death or study completion (up to 48 months from first participant enrolled).

  7. Overall survival (OS)

    Time from enrollment to death from any cause.

    Measured: Assessed every 3 months for the first 2 years, then every 6 months up to 5 years, or until death or study completion (up to 48 months from first participant enrolled).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Apr 2026
  2. Study start28 Apr 2026
  3. Primary completion1 Oct 2028 (estimated)
  4. Study completion1 Jul 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07522879
Sponsor's protocol ID
FudanENT-2026041-1
Acronym
MRG003-SACC
Status last verified
Apr 2026
First submitted
4 Apr 2026
Last updated
28 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Agulnik M, Cohen EW, Cohen RB, Chen EX, Vokes EE, Hotte SJ, Winquist E, Laurie S, Hayes DN, Dancey JE, Brown S, Pond GR, Lorimer I, Daneshmand M, Ho J, Tsao MS, Siu LL. Phase II study of lapatinib in recurrent or metastatic epidermal growth factor receptor and/or erbB2 expressing adenoid cystic carcinoma and non adenoid cystic carcinoma malignant tumors of the salivary glands. J Clin Oncol. 2007 Sep 1;25(25):3978-84. doi: 10.1200/JCO.2007.11.8612.

    PubMed 17761983
  • Vered M, Braunstein E, Buchner A. Immunohistochemical study of epidermal growth factor receptor in adenoid cystic carcinoma of salivary gland origin. Head Neck. 2002 Jul;24(7):632-6. doi: 10.1002/hed.10104.

    PubMed 12112535
  • Zhou J, Zhao G, Wang S, Li N. Systemic therapy in the management of metastatic or locally recurrent adenoid cystic carcinoma of the salivary glands: a systematic review of the last decade. Br J Cancer. 2024 Oct;131(6):1021-1031. doi: 10.1038/s41416-024-02795-4. Epub 2024 Aug 3.

    PubMed 39097677
  • Lupinetti AD, Roberts DB, Williams MD, Kupferman ME, Rosenthal DI, Demonte F, El-Naggar A, Weber RS, Hanna EY. Sinonasal adenoid cystic carcinoma: the M. D. Anderson Cancer Center experience. Cancer. 2007 Dec 15;110(12):2726-31. doi: 10.1002/cncr.23096.

    PubMed 17960615
  • Mavrikios A, Goudjil F, Beddok A, Zefkili S, Bolle S, Feuvret L, Le Tourneau C, Choussy O, Sauvaget E, Herman P, Dendale R, Calugaru V. Proton therapy and/or helical tomotherapy for locally advanced sinonasal skull base adenoid cystic carcinoma: Focus on experience of the Institut Curie and review of literature. Head Neck. 2023 Jul;45(7):1619-1631. doi: 10.1002/hed.27371. Epub 2023 Apr 25.

    PubMed 37097003

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Becotatug Vedotin in people with Adenoid Cystic Carcinoma and Sinonasal Carcinoma, run by Eye & ENT Hospital of Fudan University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 28 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Quan Liu, Director (8615001959681, liuqent@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Objective Response Rate (ORR) (time frame: 21 days (±7 days) after completion of the third cycle of neoadjuvant therapy (each cycle is 21 days).). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07522879, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jul 2026.

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