This multicenter, open-label, single-arm trial will evaluate the anti-tumor activity of ZW25 (zanidatamab) monotherapy in subjects with human epidermal growth factor receptor 2 (HER2)-amplified, inoperable and advanced or metastatic biliary tract cancer (BTC), including intra-hepatic cholangiocarcinoma (ICC), extra-hepatic cholangiocarcinoma (ECC), and gallbladder cancer (GBC).



Eligible Ages
Over 18 Years
Eligible Genders
Accepts Healthy Volunteers

Inclusion Criteria

  • Histologically- or cytologically-confirmed BTC, including ICC, ECC or GBC. - Locally advanced or metastatic BTC and not eligible for curative resection, transplantation, or ablative therapies. - Received at least 1 prior gemcitabine-containing systemic chemotherapy regimen for advanced disease, and experienced disease progression after or developed intolerance to the most recent prior therapy. For subjects who received gemcitabine in prior adjuvant or neoadjuvant treatment, if progression occurred < 6 months from the latter of primary surgical resection or completion of gemcitabine-containing adjuvant therapy, they will be considered as having received 1 prior line of therapy for advanced disease. - Subjects must test positive for HER2 amplification by ISH-assay at a central laboratory on a new biopsy or archival tissue. Note that fine needle aspirates (FNAs; cytology samples) and biopsies from sites of bone metastases are not acceptable. Testing may occur at any time after diagnosis of advanced or metastatic disease and before study enrollment. - Male or female, ≥18 years of age (or the legal age of adulthood per country-specific regulations). - Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1. - Adequate organ function. - Adequate cardiac function, as defined by left ventricular ejection fraction ≥ 50%.

Exclusion Criteria

  • Received systemic anti-cancer therapy within 3 weeks of the first dose of ZW25. Received radiotherapy within 2 weeks of the first dose of ZW25. - Prior treatment with HER2-targeted agents. - Untreated central nervous system (CNS) metastases, symptomatic CNS metastases, or radiation treatment for CNS metastases within 4 weeks of start of study treatment. Stable, treated brain metastases are allowed (defined as subjects who are off steroids and anticonvulsants and are neurologically stable with no evidence of radiographic progression for at least 4 weeks at the time of screening). - Known leptomeningeal disease (LMD). If LMD has been reported radiographically on baseline MRI, but is not suspected clinically by the investigator, the subject must be free of neurological symptoms of LMD. - Concurrent uncontrolled or active hepatobiliary disorders or untreated or ongoing complications after laparoscopic procedures or stent placement, including but not limited to active cholangitis, unresolved biliary obstruction, infected biloma or abscess. Any complications must be resolved more than 2 weeks prior to the first dose of ZW25. - Prior or concurrent malignancy whose natural history or treatment has, in the opinion of the investigator or medical monitor, the potential to interfere with the safety or efficacy assessment of the investigational regimen. - Active hepatitis - Infection with human immunodeficiency virus (HIV)-1 or HIV-2 - QTc Fridericia (QTcF) > 470 ms. - History of myocardial infarction or unstable angina within 6 months prior to enrollment, troponin levels consistent with myocardial infarction, or clinically significant cardiac disease. - Acute or chronic uncontrolled pancreatitis or Child-Pugh Class C liver disease.

Study Design

Phase 2
Study Type
Intervention Model
Single Group Assignment
Intervention Model Description
single-arm, open-label, multi-cohort, multicenter study
Primary Purpose
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
ZW25 (Zanidatamab) Monotherapy
  • Drug: ZW25 (Zanidatamab)
    Administered intravenously
  • Diagnostic Test: In situ hybridization (ISH)-based companion diagnostic assay
    Subjects will be tested for HER2 gene-amplification using the ISH-based companion diagnostic assay
  • Diagnostic Test: Immunohistochemistry (IHC)-based companion diagnostic assay
    Subjects will be tested for HER2 protein-expression using the IHC-based companion diagnostic assay

Recruiting Locations

University of Maryland Greenebaum Cancer Center
Baltimore, Maryland 21201

More Details

Zymeworks Inc.

Study Contact

Zymeworks Clinical Trial Resource
(206) 237-1030


Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.