Biliary Tract CancerPhase 2ZENITHNCT07841873
Zanidatamab Combined With Liposomal Irinotecan and Capecitabine for Second-line Treatment of HER2-positive Unresectable Biliary Tract Tumors
A Phase 2 study testing Zanidatamab in people with Biliary Tract Cancer, run by Anhui Provincial Hospital.
Trial summary
This is a prospective, multicenter, single-arm, phase II clinical study designed to explore the efficacy and safety of zanidatamab in combination with liposomal irinotecan and capecitabine as second-line therapy for HER2-positive advanced biliary tract cancer. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Biliary Tract Cancer
- What is being tested?
- Zanidatamab
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 15 participants
- Where
- No sites listed yet
- Study dates
- 30 Nov 2026to 31 Dec 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
- Informed consent: Voluntary provision of written informed consent; age ≥18 years.
- Pathologic diagnosis: Histologically or cytologically confirmed unresectable locally advanced or metastatic biliary tract cancer, including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, or gallbladder cancer.
- HER2 status: HER2 positivity confirmed by immunohistochemistry and/or fluorescence in situ hybridization, defined as IHC 3+ or IHC 2+ with FISH-confirmed amplification. Local test results from each participating center will be used for eligibility screening.
- Prior treatment:
- Disease progression after or intolerance to a standard first-line regimen containing a programmed cell death protein 1 or programmed death-ligand 1 inhibitor.
- No prior treatment with irinotecan, capecitabine, or any HER2-targeted therapy.
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- Measurable disease: At least one measurable target lesion according to RECIST version 1.1.
- Performance status: Eastern Cooperative Oncology Group performance status of 0 or 1.
- Life expectancy: ≥12 weeks.
- Adequate organ function, based on test results obtained within 14 days before the first dose:
- Hematologic function: Absolute neutrophil count ≥1.5 × 10⁹/L; hemoglobin ≥90 g/L; platelet count ≥100 × 10⁹/L.
- Hepatic function: Total bilirubin ≤1.5 × the upper limit of normal; alanine aminotransferase and aspartate aminotransferase ≤2.5 × the upper limit of normal, or ≤5 × the upper limit of normal in patients with liver metastases.
- Renal function: Serum creatinine ≤1.5 × the upper limit of normal or creatinine clearance ≥30 mL/min.
- Cardiac function: Left ventricular ejection fraction ≥50%.
- Coagulation function: International normalized ratio ≤1.5 × the upper limit of normal.
- Contraception: Patients of childbearing potential must agree to use effective contraception during the study and for 6 months after the last dose.
Who cannot join
- History of malignancy: Another active malignancy within the previous 5 years, except for cured cervical carcinoma in situ or basal cell carcinoma of the skin.
- Tumor type: Ampullary carcinoma.
- Uncontrolled conditions:
- Uncontrolled pleural effusion, ascites, or pericardial effusion. Patients requiring drainage only may be enrolled if there is no clinically significant reaccumulation within 3 days after drainage is discontinued.
- Known active central nervous system metastases and/or carcinomatous meningitis.
- Recent treatment:
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- Major surgery or radiotherapy within 4 weeks before the first dose.
- Traditional Chinese medicines with an approved antitumor indication within 2 weeks before the first dose.
- Participation in another interventional clinical study within 4 weeks before the first dose.
- Comorbidities:
- A history of myocardial infarction or unstable angina within 6 months before enrollment; troponin levels meeting diagnostic criteria for myocardial infarction; or clinically significant cardiac disease, including ventricular arrhythmias requiring treatment, uncontrolled hypertension, or any history of symptomatic heart failure.
- Active infection, including hepatitis B virus, hepatitis C virus, or human immunodeficiency virus infection.
- Patients positive for hepatitis B surface antigen must have an HBV DNA level <1,000 IU/mL and agree to receive antiviral therapy throughout the study.
- Hepatitis C virus infection, except that the following patients are eligible: (i) patients with no history of curative antiviral therapy who have a confirmed negative viral load; or (ii) patients who completed curative antiviral therapy ≥12 weeks before enrollment and have a negative viral load.
- Gastrointestinal conditions: Factors that may affect absorption of oral medication, such as chronic diarrhea or intestinal obstruction; or Grade ≥2 diarrhea.
- Drug interactions: Use of strong CYP3A4 or UGT1A1 inhibitors or inducers within 3 weeks before the first dose.
- Adverse reactions: Toxicities from prior therapy that have not recovered to Grade ≤1, except alopecia and peripheral neuropathy of Grade ≤2.
- History of a life-threatening hypersensitivity reaction to monoclonal antibodies, recombinant proteins, or any excipient in the zanidatamab formulation.
- Women who are pregnant or breastfeeding, and women or men planning to conceive a child.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Zanidatamab Combined With Liposomal Irinotecan and Capecitabine for Second-line Treatment of HER2-positive Unresectable Biliary Tract Tumors: A Multicenter, Single-arm, Phase II Clinical Study
This is a prospective, multicenter, single-arm, phase II clinical study designed to explore the efficacy and safety of zanidatamab in combination with liposomal irinotecan and capecitabine as second-line therapy for HER2-positive advanced biliary tract cancer. Fifteen patients with unresectable locally advanced or metastatic biliary tract cancer, including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, or gallbladder cancer, will be enrolled after progression on or intolerance to first-line therapy. HER2 positivity must be confirmed by immunohistochemistry and/or fluorescence in situ hybridization, defined as IHC 3+ or IHC 2+ with FISH-confirmed amplification. Zanidatamab 20 mg/kg will be administered intravenously on Day 1 every 2 weeks; liposomal irinotecan 50 mg/m² will be administered intravenously over 90 minutes on Day 2 every 2 weeks; and capecitabine 1,000 mg/m² will be administered orally twice daily on Days 1-10 of each 14-day cycle. Chemotherapy will be administered for a maximum of six cycles, and study treatment will continue until disease progression or unacceptable toxicity. The primary endpoint is objective response rate, as assessed according to Response Evaluation Criteria in Solid Tumors version 1.1. Secondary endpoints include disease control rate, duration of response, progression-free survival, overall survival, and safety.
- Conditions
- Biliary Tract Cancer
- Being tested
- Zanidatamab
- Medical subject headings
- Biliary Tract Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ZanidatamabDrug
Also called liposomal irinotecan, capecitabine
Zanidatamab 20 mg/kg will be administered intravenously on Day 1 every 2 weeks; liposomal irinotecan 50 mg/m² will be administered intravenously on Day 2 every 2 weeks; and capecitabine 1,000 mg/m² will be administered orally twice daily on Days 1-10 of each 14-day cycle. Chemotherapy will be administered for a maximum of six cycles, and study treatment will continue until disease progression or unacceptable toxicity.
| Study group | Role | What they receive |
|---|---|---|
| Treatment | Experimental | Not described Receives: Drug: Zanidatamab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Objective response rate as assessed by RECIST v 1.1
Measured: 24 months
Secondary outcomes (5)
Disease control rate as assessed by RECIST v1.1
Measured: 24 months
duration of response as assessed by RECIST v1.1
Measured: 24 months
progression-free survival as assessed by RECIST v1.1
Measured: 24 months
overall survival
Measured: 48 months
Adverse Events as Assessed by CTCAE v5.0
Measured: 24 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Sep 2026
- Study start30 Nov 2026 (estimated)
- Primary completion30 Jun 2028 (estimated)
- Study completion31 Dec 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Biliary Tract CancerStudies of the same condition, open and under way.
- More trials run by Anhui Provincial HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- 15 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Anhui Provincial Hospital
- Sponsor type
- Other government
- Responsible party
- Principal investigator, Wang Gang, Anhui Provincial Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07841873
- Sponsor's protocol ID
- 2026KY1293
- Acronym
- ZENITH
- Status last verified
- Sep 2026
- First submitted
- 20 Sep 2026
- Last updated
- 1 Oct 2026
- Results posted
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 1 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Zanidatamab Combined With Liposomal Irinotecan and Capecitabine for Second-line Treatment of HER2-positive Unresectable Biliary Tract Tumors: A Multicenter, Single-arm, Phase II Clinical Study
- ClinicalTrials.gov ID
- NCT07841873
- Acronym / sponsor ID
- ZENITH / 2026KY1293
- Conditions
- Biliary Tract Cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 15 participants (estimated)
- Lead sponsor
- Anhui Provincial HospitalOther government
- Study start
- 30 Nov 2026 (estimated)
- Primary completion
- 30 Jun 2028 (estimated)
- Study completion
- 31 Dec 2030 (estimated)
- First posted
- 25 Sep 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a prospective, multicenter, single-arm, phase II clinical study designed to explore the efficacy and safety of zanidatamab in combination with liposomal irinotecan and capecitabine as second-line therapy for HER2-positive advanced biliary tract cancer. Fifteen patients with unresectable locally advanced or metastatic biliary tract cancer, including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, or gallbladder cancer, will be enrolled after progression on or intolerance to first-line therapy. HER2 positivity must be confirmed by immunohistochemistry and/or fluorescence in situ hybridization, defined as IHC 3+ or IHC 2+ with FISH-confirmed amplification. Zanidatamab 20 mg/kg will be administered intravenously on Day 1 every 2 weeks; liposomal irinotecan 50 mg/m² will be administered intravenously over 90 minutes on Day 2 every 2 weeks; and capecitabine 1,000 mg/m² will be administered orally twice daily on Days 1-10 of each 14-day cycle. Chemotherapy will be administered for a maximum of six cycles, and study treatment will continue until disease progression or unacceptable toxicity. The primary endpoint is objective response rate, as assessed according to Response Evaluation Criteria in Solid Tumors version 1.1. Secondary endpoints include disease control rate, duration of response, progression-free survival, overall survival, and safety.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Treatment | Experimental | Drug: Zanidatamab |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (16 listed)
- Informed consent: Voluntary provision of written informed consent; age ≥18 years.
- Pathologic diagnosis: Histologically or cytologically confirmed unresectable locally advanced or metastatic biliary tract cancer, including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, or gallbladder cancer.
- HER2 status: HER2 positivity confirmed by immunohistochemistry and/or fluorescence in situ hybridization, defined as IHC 3+ or IHC 2+ with FISH-confirmed amplification. Local test results from each participating center will be used for eligibility screening.
- Prior treatment:
- Measurable disease: At least one measurable target lesion according to RECIST version 1.1.
Key exclusion criteria (19 listed)
- History of malignancy: Another active malignancy within the previous 5 years, except for cured cervical carcinoma in situ or basal cell carcinoma of the skin.
- Tumor type: Ampullary carcinoma.
- Uncontrolled conditions:
- Recent treatment:
- Comorbidities:
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ZanidatamabAlso: liposomal irinotecan, capecitabineZanidatamab 20 mg/kg will be administered intravenously on Day 1 every 2 weeks; liposomal irinotecan 50 mg/m² will be administered intravenously on Day 2 every 2 weeks; and capecitabine 1,000 mg/m² will be administered orally twice daily on Days 1-10 of each 14-day cycle. Chemotherapy will be administered for a maximum of six cycles, and study treatment will continue until disease progression or unacceptable toxicity. | Drug | Treatment |
Primary outcome
Objective response rate as assessed by RECIST v 1.1
Time frame: 24 months
5 secondary outcomes
Disease control rate as assessed by RECIST v1.1
Time frame: 24 months
duration of response as assessed by RECIST v1.1
Time frame: 24 months
progression-free survival as assessed by RECIST v1.1
Time frame: 24 months
overall survival
Time frame: 48 months
Adverse Events as Assessed by CTCAE v5.0
Time frame: 24 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Oct 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Zanidatamab in people with Biliary Tract Cancer, run by Anhui Provincial Hospital.
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 16 inclusion and 19 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: opening soon, as of the sponsor's last update on 1 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
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 gang wang (+8613855196707, wanggang829@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Objective response rate as assessed by RECIST v 1.1 (time frame: 24 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 1 Oct 2026.