BL-B01D1 versus doctor‑chosen chemotherapy for platinum‑resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer

A Phase III Randomized Controlled Clinical Study Comparing BL-B01D1 With the Investigator's Choice of Chemotherapy in Patients With Platinum-resistant Recurrent Epithelial Ovarian Cancer

This tests whether BL-B01D1 works better than the doctor’s choice of chemotherapy for adults with platinum‑resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer.

Quick facts

• Phase: PHASE3
• Study type: Interventional
• Enrollment: 384 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Sichuan Baili Pharmaceutical Co., Ltd. (industry)
• Drugs / interventions: mirvetuximab, chemotherapy, radiation
• Locations: 1 site (Shanghai, Shanghai Municipality)
• Trial ID: NCT06994195 on ClinicalTrials.gov

What this trial studies

This is a phase III, randomized, open‑label, multicenter trial comparing BL-B01D1 to investigator‑chosen chemotherapy (liposomal doxorubicin, paclitaxel, or topotecan) in patients with platinum‑resistant recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer. Eligible participants have histologically or cytologically confirmed disease, prior platinum exposure with platinum‑resistant recurrence, and 1–3 prior lines of systemic therapy, and must have at least one RECIST v1.1 measurable lesion and provide tumor tissue. Patients with documented folate receptor‑alpha positivity have additional prior-therapy considerations noted in the protocol. Participants are randomized to receive BL-B01D1 or the treating physician’s selected chemotherapy and are followed for efficacy and safety endpoints.

Who should consider this trial

Good fit: Adults (≥18) with histologically or cytologically confirmed epithelial ovarian, fallopian tube, or primary peritoneal cancer who have platinum‑resistant recurrence, 1–3 prior systemic therapies, measurable disease, and willingness to provide tumor tissue are ideal candidates.

Not a fit: Patients who are not platinum‑resistant, have had more than three prior lines of systemic therapy, lack measurable disease, or cannot provide required tumor tissue or attend study visits are unlikely to qualify or benefit.

Why it matters

Potential benefit: If successful, BL-B01D1 could offer a more effective treatment option than current chemotherapy choices for patients with platinum‑resistant recurrent disease.

How similar studies have performed: Other trials of targeted agents and antibody‑drug conjugates in platinum‑resistant ovarian cancer have shown mixed results, so BL-B01D1 represents a promising but not yet proven approach.

Eligibility criteria

Inclusion Criteria:

1. Voluntarily sign the informed consent form and comply with the protocol requirements;
2. Age: ≥18 years old;
3. Expected survival time ≥3 months;
4. Histologically or cytologically confirmed epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer;
5. Previously treated with a platinum-based regimen and confirmed to have platinum-resistant recurrence;
6. Previously received 1-3 lines of systemic anti-tumor therapy, with radiographic evidence of disease progression during or after the last line of treatment or intolerance to the current treatment prior to randomization;
7. For subjects with documented folate receptor-alpha (FRα) positivity, progression must have occurred after treatment with mirvetuximab soravtansine;
8. Agree to provide archived tumor tissue specimens or fresh tissue samples from the primary or metastatic lesions within the past 3 years;
9. Must have at least one measurable lesion as defined by RECIST v1.1;
10. ECOG performance status score of 0 or 1;
11. Toxicity from prior anti-tumor therapy has recovered to ≤ Grade 1 as defined by NCI-CTCAE v5.0;
12. No severe cardiac dysfunction, with left ventricular ejection fraction ≥50%;
13. Organ function levels must meet the requirements;
14. Coagulation function: International Normalized Ratio (INR) ≤1.5, and activated partial thromboplastin time (APTT) ≤1.5×ULN;
15. For premenopausal women with childbearing potential, a serum pregnancy test must be performed within 7 days before starting treatment, and the result must be negative; they must not be breastfeeding. All enrolled patients should use adequate barrier contraception throughout the treatment period and for 6 months after treatment ends.

Exclusion Criteria:

1. Use of chemotherapy, targeted therapy, biologic therapy, etc., within 4 weeks or 5 half-lives prior to study randomization and palliative radiotherapy, etc., within 2 weeks;
2. Patients with locally advanced or metastatic platinum-resistant recurrent epithelial ovarian cancer who are eligible for radical locoregional therapy;
3. Front line received ADCs targeting topoisomerase I inhibitors or EGFR and/or HER3;
4. History of severe heart disease and cerebrovascular disease;
5. Unstable thrombotic events requiring therapeutic intervention within 6 months before screening;
6. Prolonged QT interval, complete left bundle branch block, III degree atrioventricular block, frequent and uncontrollable arrhythmia;
7. Diagnosed with active malignancy within 3 years before randomization;
8. Hypertension poorly controlled by two antihypertensive drugs;
9. Patients with poor glycemic control;
10. Patients with grade ≥1 radiation pneumonitis according to the RTOG/EORTC definition; Previous history of ILD;
11. Complicated with pulmonary diseases leading to clinically severe respiratory function impairment;
12. Patients with active central nervous system metastases;
13. Severe infection occurred within 4 weeks before randomization in study 13; Evidence of pulmonary infection or active pulmonary inflammation within 2 weeks before randomization;
14. Patients with massive or symptomatic effusions or poorly controlled effusions;
15. Imaging examination showed that the tumor had invaded or enveloped the large blood vessels in the abdomen, chest, neck, and pharynx;
16. Serious unhealed wound, ulcer or fracture within 4 weeks before signing the informed consent;
17. Subjects with clinically significant bleeding or obvious bleeding tendency within 4 weeks before signing the informed consent;
18. Patients with inflammatory bowel disease, extensive bowel resection, immune enteritis, intestinal obstruction or chronic diarrhea;
19. Patients with a history of allergy to recombinant humanized antibodies or to any of the excipients of BL-B01D1;
20. Had a history of autologous or allogeneic stem cell transplantation;
21. Human immunodeficiency virus antibody positive, active hepatitis B virus infection or hepatitis C virus infection;
22. A history of severe neurological or psychiatric illness;
23. Received other unmarketed investigational drugs or treatments within 4 weeks before randomization;
24. Subjects who were scheduled to be vaccinated or received live vaccine within 28 days before study randomization;
25. Other circumstances in which the investigator considered it inappropriate to participate in the trial because of complications or other circumstances.

Where this trial is running

Shanghai, Shanghai Municipality

• Fudan University Shanghai Cancer Center — Shanghai, Shanghai Municipality, China (RECRUITING)

Study contacts

• Study coordinator: Sa Xiao, PHD

Conditions: Epithelial Ovarian Cancer, Fallopian Tube Cancer, Primary Peritoneal Cancer