ClinicalTrials.gg
Not yet recruitingNCT04910386Updated Mar 25, 2026

Multicenter Phase 2 Study of Envafolimab in Biliary Tract Cancers

A Phase 2 interventional study of Envafolimab plus Gemcitabine&Cisplatin and Gemcitabine&Cisplatin in Biliary Tract Neoplasms, sponsored by 3D Medicines (Sichuan) Co., Ltd.. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-25.

Sponsored by 3D Medicines (Sichuan) Co., Ltd. · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
126
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a Randomized, Open-Label, Multicenter Phase 2 Study to access the efficacy and safety of Envafolimab in Combination with Gemcitabine Plus Cisplatin Versus Gemcitabine Plus Cisplatin as the First-line Treatment in Patients with Locally Advanced or Metastatic Biliary Tract Cancers

02

Conditions studied

  • Biliary Tract Neoplasms
03

In context

Biliary Tract Neoplasms

519 studies on the registry are indexed under Biliary Tract Neoplasms; 199 are open to participants now.

This study's planned enrollment of 126 is above the median of 58 across 427 interventional studies indexed under Biliary Tract Neoplasms.

Browse Biliary Tract Neoplasms studies →

Lead sponsor

3D Medicines (Sichuan) Co., Ltd. is the lead sponsor of 11 studies on the registry; 5 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Be ≥ 18 years of age;
  2. Subjects must have a histopathological or cytological diagnosis of locally advanced or gallbladder cancer (GBC) or cholangiocarcinoma (CCA);
  3. Subjects who have not received prior systemic therapy for advanced disease or who have received or neoadjuvant chemotherapy in one regimen and > 6 months after the end of chemotherapy can be enrolled;
  4. liver function rating: class A (5-6 points) and better class B (7 points) (see Appendix 3);
  5. PS score 0 or 1 (see Appendix 1);
  6. Expected survival ≥ 12 weeks;
  7. Subjects with at least one ( 1.1 criteria, see Appendix 2);
  8. Subject must have adequate major organ and bone marrow functions (no blood transfusion and no use of hematopoietic growth factor within 14 days before the first dose of study treatment):

1) Hematology: neutrophils ≥ 1.5 × 109/L, ≥ 100 × 109/L, and ≥ 90 g/L; 2) (INR) ≤ 1.5 × (ULN) and activated partial thromboplastin time (APTT) ≤ 1.5 × ULN; 3) Liver function: serum total ≤ 1.5 × ULN or direct bilirubin ≤ ULN for subjects with total bilirubin levels >1.5 ULN; (AST [SGOT]) and alanine aminotransferase (ALT [SGPT]) ≤ 2.5 × ULN OR ≤ 5 × ULN for subjects with liver metastases; 4) Renal function: serum creatinine ≤ 1.5 x ULN and (CCr) > 60 mL/min (assessed with Cockcroft-Gault formula, see Appendix 6); 5) Normal cardiac function with (LVEF) ≥ 50% by two-dimensional echocardiography.

9. Subjects must fully understand the study, voluntarily participate, and sign the form (ICF).

Exclusion criteria

Exclusion Criteria:

  1. Has participated in another clinical trials of other drugs or investigational devices within 4 weeks prior to the first dose of investigational product treatment (palliative radiotherapy for bone completed at least 2 weeks prior to investigational product treatment is allowed);
  2. The investigator assesses liver metastases as 50% or more of the total liver volume;
  3. Has ascites requiring drainage or treatment with diuretics, or pleural or pericardial effusion requiring drainage and/or associated with symptoms of tachypnea within 4 weeks prior to the first dose of investigational product treatment;
  4. Has biliary obstruction with clinical intervention that has not resolved or requires anti-infective therapy as judged by the investigator 14 days prior to the first dose of investigational product treatment;
  5. Has prior liver transplantation;
  6. Has known active or spinal cord compression; subjects with previously treated brain metastases may be enrolled if their clinical condition is stable and radiographic evidence shows no disease progression within 4 weeks prior to the first dose of investigational product treatment, and therapy is not required within 4 weeks prior to the first dose of investigational product treatment;
  7. Has a known additional malignant tumor in the past 5 years (except for skin basal cell or squamous cell carcinoma, or cervical, breast and other carcinoma in situ after radical surgery);
  8. Has received major surgical procedures (except ) or incomplete healing of surgical wound within 4 weeks prior to the first dose of investigational product treatment;
  9. Has any unresolved toxicity ( Grade ≥ 2) from prior anti-tumor therapy, except for alopecia or Grade 2 peripheral neuropathy or other laboratory abnormalities that are not as assessed by the investigator;
  10. Has an active disease or a documented history of autoimmune disease or syndrome that requires systemic steroids or agents. Subjects with vitiligo or resolved childhood asthma/atopy would be exception to this rule. Subjects who require intermittent use of bronchodilators or local steroid injections would not be excluded from the study. Subjects with hypothyroidism that is stable on hormone replacement will not be excluded from the study;
  11. Has known history of , or active bacterial or fungal infection requiring systemic treatment within 14 days prior to the first dose of investigational product treatment;
  12. Has history of interstitial lung disease, drug-induced interstitial lung disease, radiation pneumonitis, symptomatic interstitial lung disease or presence of active pneumonitis on chest CT scan within 4 weeks before the first dose of investigational product treatment;
  13. Has active (HBsAg positive and HBV-DNA ≥ 104 copies/mL) or (HCV antibody positive and HCV-RNA quantitative test results greater than the lower limit of detection);
  14. Has a history or current evidence of clinically significant cardiovascular diseases, including but not limited to acute myocardial infarction, severe/unstable angina, acute ischemic/hemorrhagic stroke, congestive heart failure (≥ Class II, see Appendix 4) within 6 months prior to enrollment; arrhythmias requiring treatment with other antiarrhythmic drugs in addition to β-blockers or digoxin; repeat interval > 450 milliseconds (ms) on (see Appendix 5); hypertension not well controlled with antihypertensive drug therapy (systolic blood pressure > 150 mmHg, diastolic blood pressure > 100 mmHg);
  15. Be receiving therapeutic doses of warfarin (low-dose warfarin ≤ 2 mg/day is allowed); or receiving antiplatelet anticoagulant therapy (aspirin doses ≤ 300 mg/day and clopidogrel doses ≤ 75 mg/day are allowed);
  16. Has received immunosuppressive drugs within 4 weeks prior to the first dose of investigational product treatment, excluding topical corticosteroids or systemic prednisone ≤ 10 mg/day or equivalent doses of other corticosteroids;
  17. Has received within 4 weeks before the first dose of investigational product treatment or plan to receive it during the study;
  18. Has history of severe allergic reactions to chimeric or human antibodies or fusion proteins, or known allergies to biological products produced with Chinese hamster ovary cells or any component of envafolimab; known or suspected allergy to the chemotherapeutic drug gemcitabine/cisplatin and its components;
  19. Be pregnant or breastfeeding;
  20. Be but unwilling to accept effective measures;
  21. Any other disease, metabolic disorder or laboratory abnormalities, that the investigator considers that the subject is not suitable for the investigational product treatment, or will affect the interpretation of the study results, or put the subject at high risk.
Terms in these criteria, in plain language(33)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
126 participants (estimated)

Study arms

  • Experimental
    Envafolimb

    Envafolimab plus Gemcitabine\&Cisplatin Envafolimab: 300 mg on Day 1 of each cycle, subcutaneous injection. Every 21 days is a treatment cycle. Gemcitabine (GEM): 1000 mg/m2 body surface area (BSA) administered on Days 1 and 8 of each cycle. Every 21 days is a treatment cycle with a maximum of 8 cycles. Cisplatin (CIS): 25 mg/m2 body surface area (BSA) administered on Days 1 and 8 of each cycle. Every 21 days is a treatment cycle with a maximum of 8 cycles.

    Drug: Envafolimab plus Gemcitabine&Cisplatin

  • Active comparator
    Gemcitabine&Cisplatin

    Gemcitabine (GEM): 1000 mg/m2 body surface area (BSA) administered on Days 1 and 8 of each cycle. Every 21 days is a treatment cycle with a maximum of 8 cycles. Cisplatin (CIS): 25 mg/m2 body surface area (BSA) administered on Days 1 and 8 of each cycle. Every 21 days is a treatment cycle with a maximum of 8 cycles.

    Drug: Gemcitabine&Cisplatin

Interventions

  • DrugEnvafolimab plus Gemcitabine&Cisplatin

    Envafolimab a programmed death ligand immune check inhibitor Per Investigator decision

  • DrugGemcitabine&Cisplatin

    The standard of care for the patients with unresectable/metastatic biliary tract cancer

06

What researchers measure

Primary outcomes

  1. Progression-free survival (PFS)

    To evaluate the progression-free survival (PFS) of envafolimab in combination with gemcitabine plus cisplatin (GemCis) versus first-line treatment of GemCis in patients with advanced biliary tract cancers (BTC).

    Time frame: Observed by 12 weeks

Secondary outcomes

  1. Overall survival (OS)

    To evaluate the overall survival (OS) of envafolimab in combination with GemCis versus GemCis in patients with advanced BTC;

    Time frame: Observed by 12 weeks after progressive disease or end of treatment

  2. Objective response rate(ORR)

    To evaluate the objective response rate (assessed by the investigator per RECIST 1.1 criteria) of envafolimab in combination with GemCis versus GemCis in patients with advanced BTC;

    Time frame: Observed by 12 weeks

  3. Duration of response (DoR)

    To evaluate the duration of response (assessed by the investigator per RECIST 1.1 criteria) of envafolimab in combination with GemCis versus GemCis in patients with advanced BTC;

    Time frame: Observed by 12 weeks

  4. Disease control rate (DCR)

    To evaluate the disease control rate (assessed by the investigator per RECIST 1.1 criteria) of envafolimab in combination with GemCis versus GemCis in patients with advanced BTC;

    Time frame: Observed by 12 weeks

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Jun 2027; primary completion for Jun 2029, 24 months later.

Of 129 phase 2 interventional studies under Biliary Tract Neoplasms, half reached primary completion within 39 months of starting (the median), counting those still running; a quarter within 29 and three quarters within 68. This study's planned 24 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
May 27, 2021
First posted
Jun 2, 2021
StartEst.
Jun 1, 2027
Primary completionEst.
Jun 2029
CompletionEst.
Dec 2029
Last update
Mar 25, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 25, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04910386
Lead sponsor
3D Medicines (Sichuan) Co., Ltd.
Responsible party
Sponsor
First posted
Jun 2, 2021
Start date
Jun 1, 2027 (estimated)
Primary completion
Jun 2029 (estimated)
Completion
Dec 2029 (estimated)
Last update
Mar 25, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is not yet recruiting, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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