A Phase 2 interventional study of Intrathecal and systemic administration of Trastuzumab Rezetecan in Leptomeningeal Metastases and Solid Tumors, sponsored by Jiuda Zhao. Not yet recruiting at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-22.
Sponsored by Jiuda Zhao · Phase 2, Interventional, and Treatment
This phase II clinical study enrolls patients with leptomeningeal metastases from solid tumors. Participants will receive intrathecal and systemic administration of Trastuzumab Rezetecan. The study aims to obtain clinical evidence about the efficacy and safety of this antibody-drug conjugate (ADC) given via intrathecal plus systemic routes. It hopes to offer a new treatment option for these patients with hard-to-manage disease and provide scientific support for optimizing treatment strategies for solid tumor patients with leptomeningeal metastases.
This is a prospective, multicenter, single-arm, dual-cohort phase II clinical trial. It is designed to evaluate the efficacy and safety of combined intravenous and intrathecal Trastuzumab Rezetecan in adult patients with leptomeningeal metastases (LMD) from solid tumors.Participants are stratified into two cohorts based on HER2 expression and mutation status. All enrolled patients receive dualroute treatment with intravenous plus intrathecal Trastuzumab Rezetecan. The systemic intravenous dose is 4.8 mg/kg administered every 3 weeks, with a 21-day treatment cycle. The intrathecal dose is set at 20% of the single systemic dose. In terms of administration schedule, intrathecal injection is performed once weekly during Cycle 1 and Cycle 2, and once per treatment cycle starting from Cycle 3.The primary endpoint is the 3-month overall survival (OS) rate. Secondary endpoints cover intracranial tumor response and survival outcomes, cerebrospinal fluid tumor cell clearance rate, and extracranial tumor response. This study also evaluates treatment-related adverse events according to NCI-CTCAE v5.0 and assesses patients' quality of life using the EORTC QLQ-C30 questionnaire.
146 studies on the registry are indexed under Meningeal Carcinomatosis; 47 are open to participants now.
This study's planned enrollment of 28 is close to the median of 30 across 128 interventional studies indexed under Meningeal Carcinomatosis.
Browse Meningeal Carcinomatosis studies →Jiuda Zhao is the lead sponsor of 10 studies on the registry; 7 are open to participants now.
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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.
Exclusion Criteria:
Concurrent severe systemic diseases, including but not limited to:
4.1 Active disease or CNS infection; 4.2 Active infections (e.g., pulmonary tuberculosis, active , infection); 4.3 Moderate to severe hepatic or renal dysfunction ( (ALT)/aspartate aminotransferase (AST) > 3 × , (CrCl) \< 30 ml/min); 4.4 Uncontrolled heart failure, severe arrhythmia or hypertension; 4.5 Known inherited or acquired bleeding/thrombotic tendency (e.g., hemophilia, coagulopathy, thrombocytopenia); and/or coagulation disorders ( (INR) > 2.0, prothrombin time (PT) > 16 s) with bleeding risk, or receiving thrombolysis or anticoagulant treatment.
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.
The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).
Your pathology report is the document that shows this.
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.
Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.
Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.
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.
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.
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.
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.
HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.
In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.
Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.
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.
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.
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.
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.
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.
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.
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.
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Histologically or cytologically confirmed
The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).
Your pathology report is the document that shows this.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Leptomeningeal disease
Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.
Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
HER2
HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.
In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Hypersensitivity
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
All enrolled participants receive intrathecal plus systemic administration of Trastuzumab Rezetecan. Subjects are stratified into two predefined cohorts based on HER2 status. Cohort 1: Patients with leptomeningeal disease (LMD) from solid tumors without HER2 positivity or HER2 mutations.Cohort 2: Patients with leptomeningeal disease (LMD) secondary to solid tumors with HER2 protein overexpression or HER2-activating mutations
Drug: Intrathecal and systemic administration of Trastuzumab Rezetecan
Trastuzumab-rezetecan is administered via combined intrathecal and systemic routes. Systemic dosing: 4.8 mg/kg by intravenous infusion once every 3 weeks (q3w). Intrathecal dosing: 20% of the systemic dose, administered once weekly during Cycle 1 and Cycle 2, then once every 3 weeks from Cycle 3 onward.
3-month Overall Survival Rate
3-month overall survival (OS) rate is defined as the percentage of all enrolled participants who are still alive at 3-months from the date of receiving study treatment.
Time frame: 3-months from the date of receiving study treatment
Leptomeningeal Metastasis-Progression-Free Survival (LM-PFS)
Time from treatment initiation to the first documentation of leptomeningeal metastasis progression (based on neurological examination, cerebrospinal fluid testing, or neuraxis MRI) or death from any cause, whichever occurs first, in patients with solid tumor-associated leptomeningeal metastasis receiving intrathecal plus intravenous Trastuzumab Rezetecan.
Time frame: From treatment initiation until disease progression, death, or study discontinuation, assessed up to 18 months.
Leptomeningeal Metastasis-Objective Response Rate (LM-ORR)
LM-ORR corresponds to Best Overall Response. It is not a single time-point assessment, but the best leptomeningeal metastasis therapeutic response documented from treatment initiation up to disease progression, study discontinuation, death, or pre-specified maximum follow-up.
Time frame: From treatment initiation until disease progression, death, or study discontinuation, assessed up to 18 months.
Cerebrospinal Fluid Cytology Conversion Rate
For intrathecal treatment: Trastuzumab rezetecan is administered intrathecally once weekly in Cycle 1 and Cycle 2; starting from Cycle 3 and thereafter, intrathecal Trastuzumab rezetecan is given once per 3-week cycle. The cerebrospinal fluid cytology conversion rate is preliminarily evaluated after 6-week intrathecal treatment. Sustained absence of tumor cells in cerebrospinal fluid at this time point is defined as cerebrospinal fluid conversion to negative. The cerebrospinal fluid cytology conversion rate is calculated as: (Number of patients with negative cerebrospinal fluid tumor cells at 6-week post-treatment ÷ Total number of treated patients with leptomeningeal metastasis) × 100%
Time frame: 6 weeks after initiation of intrathecal study treatment
Extracranial Objective Response Rate (EC-ORR)
EC-ORR is defined as the percentage of patients whose best overall response of extracranial lesions is complete response (CR) or partial response (PR). Tumor assessments are performed per RECIST version 1.1from the date of first study treatment until study discontinuation secondary to disease progression.
Time frame: From treatment initiation until disease progression, death, or study discontinuation, assessed up to 18 months.
Leptomeningeal Metastasis-Second Progression-Free Survival (LM-PFS2)
The measurement time of PFS2 is from the date of first disease progression to the date of second disease progression or death. LM-PFS2 is defined as the time from the first leptomeningeal metastasis progression to second leptomeningeal metastasis progression or death from any cause, whichever occurs first. Patients without the above-mentioned events will be censored at the date of last valid follow-up.
Time frame: From the date of first leptomeningeal metastasis progression until second leptomeningeal metastasis progression, death, or study discontinuation, assessed up to 18 months.
Adverse events (AEs)
Number of subjects with treatment-related adverse events, which will be assessed and graded according to NCI-CTCAE version 5.0 criteria.
Time frame: From treatment initiation until 30-day safety follow-up after last study drug administration, assessed up to 18 months.
Changes in the dimensions of the EORTC QLQ-C30 scale
Physical functioning, role functioning, emotional functioning, cognitive functioning, social functioning, and global health status before and after treatment. EORTC QLQ-C30 scores range from 0 to 100. Higher scores represent better quality of life.
Time frame: FFrom treatment initiation up to 21 days after the last treatment cycle
Plan to share: No — Individual participant data (IPD) will not be shared publicly. This is an investigator-initiated single-arm phase II trial. Restrictions from institutional ethics requirements, patient-related privacy protection regulations, and limited dedicated data-sharing resources prevent public release of de-identified individual-level participant data. Aggregated summary study results will be published in peer-reviewed journals.
No publications or documents are linked to this record.
This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.
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Jiuda Zhao