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A Study of BL-B01D1 in Patients With Locally Advanced or Metastatic Gastrointestinal Tumor and Other Solid Tumor

Primary Purpose

Gastrointestinal Tumor

Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
BL-B01D1
Sponsored by
Sichuan Baili Pharmaceutical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastrointestinal Tumor focused on measuring Esophageal Cancer (EC), Gastric Cancer (GC), Pancreatic Cancer (PC), Colorectal Cancer (CRC)

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Participants must sign the informed consent form voluntarily and follow the plan requirements.
  2. No gender limit.
  3. Age: ≥18 years old and ≤75 years old (phase Ia); ≥18 years old (phase Ib).
  4. Expected survival time ≥ 3 months.
  5. Patients with locally advanced or metastatic triple-negative breast cancer or other solid tumors who have been diagnosed histopathologically and/or cytologically as failing standard therapy, or who are not eligible for standard therapy at this stage, and who are inoperable.
  6. Agree to provide archived tumor tissue samples or fresh tissue samples from the primary tumor or metastatic tumor within 3 years (TROP2 protein expression in tumor pathological tissue to explore the correlation between TROP2 protein expression and BL-M02D1 validity index); If subjects are unable to provide tumor tissue samples, they will be admitted after evaluation by the investigator if other admission criteria are met.
  7. Participants must have at least one assessable lesion as defined by RECIST V1.1.
  8. Has an Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1
  9. The toxicity of previous anti-tumor therapy has been restored to level ≤1 as defined by NCI-CTCAE V5.0 (except for asymptomatic laboratory abnormalities such as elevated ALP, hyperuricemia, elevated serum amylase/lipase, and elevated blood glucose; except for toxicity that the investigator determined to have no safety risk, such as alopecia, grade 2 peripheral neurotoxicity, hypothyroidism stabilized by hormone replacement therapy, etc.)
  10. Has adequate organ function before registration, defined as: a) Bone marrow function: Absolute neutrophil count (ANC) ≥1.5×109/L, Platelet count ≥90×109/L, Hemoglobin ≥90 g/L; B) Hepatic function: Total bilirubin (TBIL≤1.5 ULN), AST and ALT ≤2.5 ULN for participants without liver metastasis, AST and ALT ≤5.0 ULN for liver metastases; c) Renal function: Creatinine (Cr) ≤1.5 ULN, or creatinine clearance (Ccr) ≥50 mL/min (according to the Cockcroft and Gault formula).
  11. Coagulation function: International normalized ratio (INR)≤1.5, and activated partial thromboplastin time (APTT)≤1.5ULN.
  12. Urinary protein ≤2+ or ≤1000mg/24h.
  13. For premenopausal women with childbearing potential, a pregnancy test must be taken within 7 days prior to the start of treatment. Serum or urine pregnancy must be negative and must be non-lactating. Adequate barrier contraceptive measures should be taken during the treatment and 6 months after the end of treatment for all participants (regardless of male or female).

Exclusion Criteria:

Patients screened for any of the following conditions will not be included in this study:

  1. Chemotherapy, biological therapy, immunotherapy, radical radiotherapy, major surgery, targeted therapy (including small molecule inhibitor of tyrosine kinase), and other anti-tumor therapy within 4 weeks or 5 half-lives (whichever is shorter) prior to the first administration; mitomycin and nitrosoureas treatment within 6 weeks prior to the first administration; oral fluorouracil-like drugs such as S-1, capecitabine, or palliative radiotherapy within 2weeks prior to the first administration.
  2. Prior treatment with ADC drugs targeting TROP2 or ADC drugs using camptothecin derivatives (topoisomerase I inhibitors) as toxins.
  3. Participants with history of severe heart disease, such as: symptomatic congestive heart failure (CHF) ≥ grade 2 (CTCAE 5.0), New York Heart Association (NYHA) ≥ grade 2 heart failure, history of transmural myocardial infarction, unstable angina pectoris etc.
  4. Participants with prolonged QT interval (male QTc> 450 msec or female QTc> 470 msec), complete left bundle branch block, III grade atrioventricular block.
  5. Active autoimmune diseases and inflammatory diseases, such as: systemic lupus erythematosus, psoriasis requiring systemic treatment, rheumatoid arthritis, inflammatory bowel disease and Hashimoto's thyroiditis, etc., except for type I diabetes, hypothyroidism that can be controlled only by alternative treatment, and skin diseases that do not require systemic treatment (such as vitiligo, psoriasis).
  6. The presence of a second primary tumor within 5 years prior to initial administration, except for radical basal cell carcinoma of the skin, squamous cell carcinoma of the skin, and/or radical resected carcinoma in situ.
  7. Screening for unstable thrombotic events such as deep vein thrombosis, arterial thrombosis and pulmonary embolism requiring therapeutic intervention within the first 6 months; Infusion device-related thrombosis is excluded;
  8. Patients with poorly controlled pleural effusion with clinical symptoms were judged by researchers to be unsuitable for inclusion.
  9. Participants with poorly controlled hypertension by antihypertensive drugs (systolic blood pressure>150 mmHg or diastolic blood pressure>100 mmHg).
  10. Lung disease defined as grade ≥3 according to CTCAE V5.0; ≥2 grade of radioactive lung disease, current or history of interstitial lung disease (ILD).
  11. Symptoms of active central nervous system metastasis. However, participants with stable brain metastasis can be included. Stable is defined as: a. With or without antiepileptic drugs, the seizure-free state lasts for more than 12 weeks; b. There is no need to use glucocorticoids; c. Continuous multiple MRI (scanning interval at least 8 weeks) showed a stable state in imaging; d. Stable after treatment for more than 1 month without symptoms;
  12. Participants who have a history of allergies to recombinant humanized antibodies or human-mouse chimeric antibodies or any of the components of BL-M02D1.
  13. Participants have a history of organ transplantation or allogeneic stem cell transplantation (Allo-HSCT).
  14. In the adjuvant (or neoadjuvant) treatment of anthracyclines, the cumulative dose of anthracyclines is> 360 mg/m2.
  15. Human immunodeficiency virus antibody (HIVAb) positive, active tuberculosis, active hepatitis B virus infection (HBV-DNA copy number> the lower limit of detection) or active hepatitis C virus infection (HCV antibody positive and HCV-RNA > the lower limit of detection).
  16. Participants with active infections requiring systemic treatment, such as severe pneumonia, bacteremia, sepsis, etc.
  17. Participated in another clinical trial within 4 weeks prior to participating in the study.
  18. Pregnant or nursing women.
  19. Other conditions that the investigator believes that it is not suitable for participating in this clinical trial.

Sites / Locations

  • Beijing Cancer HospitalRecruiting
  • The First Affiliated Hospital of Nanchang UniversityRecruiting
  • Jinan Central HospitalRecruiting
  • West China Hospital, Sichuan UniversityRecruiting
  • Tianjin Medical University General HospitalRecruiting
  • Zhejiang Cancer HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Study treatment

Arm Description

Participants receive BL-B01D1 as intravenous infusion for the first cycle (3 weeks). Participants with clinical benefit could receive additional treatment for more cycles. The administration will be terminated because of disease progression or intolerable toxicity occurring or other reasons.

Outcomes

Primary Outcome Measures

Phase Ia: Dose limiting toxicity (DLT)
DLTs are assessed according to NCI-CTCAE v5.0 during the first cycle and defined as occurrence of any of the toxicities in DLT definition if judged by the investigator to be possibly, probably or definitely related to study drug administration.
Phase Ia: Maximum tolerated dose (MTD)
MTD is defined as the highest dose level at which no more than 1 in 6 participants experienced a DLT during the first cycle .
Phase Ib: Recommended Phase II Dose (RP2D)
The RP2D is defined as the dose level chosen by the sponsor (in consultation with the investigators) for phase II study, based on safety, tolerability, efficacy, PK, and PD data collected during the dose escalation study of BL-B01D1

Secondary Outcome Measures

Treatment-Emergent Adverse Event (TEAE)
TEAE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally emerging, or any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition during the treatment of BL-B01D1 . The type, frequency and severity of TEAE will be evaluated during the treatment of BL-B01D1 .
Cmax
Maximum serum concentration (Cmax) of BL-B01D1 will be investigated.
Tmax
Time to maximum serum concentration (Tmax) of BL-B01D1 will be investigated
T1/2
Half-life (T1/2) of BL-B01D1 will be investigated
AUC0-t
AUC0-t is defined as area under the serum concentration-time curve from time 0 to the time of the last measurable concentration.
CL (Clearance)
CL in the serum of BL-B01D1 per unit of time will be investigated
Ctrough
Ctough is defined as the lowest serum concentration of BL-B01D1 prior to the next dose will be administered
ADA (anti-drug antibody)
Incidence and titer of ADA of BL-B01D1 will be evaluated
Nab (neutralizing antibody)
Incidence and titer of Nab of BL-B01D1 will be evaluated.
Objective Response Rate (ORR)
ORR is defined as the percentage of participants, who has a CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions). The percentage of participants who experiences a confirmed CR or PR is according to RECIST 1.1.
Disease Control Rate (DCR)
The DCR is defined as the percentage of participants who has a CR, PR, or Stable Disease (SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease [PD: at least a 20% increase in the sum of diameters of target lesions and an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD]).
Duration of Response (DOR)
The DOR for a responder is defined as the time from the participant's initial objective response to the first date of either disease progression or death, whichever occurs first.
Progression-free Survival (PFS)
The PFS is defined as the time from the participant's first dose of BL-B01D1 to the first date of either disease progression or death, whichever occurs first.

Full Information

First Posted
February 21, 2022
Last Updated
March 13, 2023
Sponsor
Sichuan Baili Pharmaceutical Co., Ltd.
Collaborators
SystImmune Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05262491
Brief Title
A Study of BL-B01D1 in Patients With Locally Advanced or Metastatic Gastrointestinal Tumor and Other Solid Tumor
Official Title
A Phase I Clinical Study to Evaluate the Safety, Tolerability, Pharmacokinetic Characteristics and Preliminary Efficacy of BL-B01D1 in Patients With Locally Advanced or Metastatic Gastrointestinal Tumor and Other Solid Tumor
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 14, 2022 (Actual)
Primary Completion Date
November 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sichuan Baili Pharmaceutical Co., Ltd.
Collaborators
SystImmune Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
In phase Ia study, the safety and tolerability of BL-B01D1 in patients with locally advanced or metastatic gastrointestinal tumor and other solid tumor will be investigated to determine the dose-limiting toxicity (DLT), maximum tolerated dose (MTD) of BL-B01D1. In phase Ib study, the safety and tolerability of BL-B01D1 at the phase Ia recommended dose will be further investigated, and recommended phase II dose (RP2D) for phase II clinical studies will be determined. In addition, the preliminary efficacy, pharmacokinetic characteristics, and immunogenicity of BL-B01D1 in patients with locally advanced or metastatic gastrointestinal tumor and other solid tumor will be evaluated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastrointestinal Tumor
Keywords
Esophageal Cancer (EC), Gastric Cancer (GC), Pancreatic Cancer (PC), Colorectal Cancer (CRC)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
96 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Study treatment
Arm Type
Experimental
Arm Description
Participants receive BL-B01D1 as intravenous infusion for the first cycle (3 weeks). Participants with clinical benefit could receive additional treatment for more cycles. The administration will be terminated because of disease progression or intolerable toxicity occurring or other reasons.
Intervention Type
Drug
Intervention Name(s)
BL-B01D1
Intervention Description
Administration by intravenous infusion
Primary Outcome Measure Information:
Title
Phase Ia: Dose limiting toxicity (DLT)
Description
DLTs are assessed according to NCI-CTCAE v5.0 during the first cycle and defined as occurrence of any of the toxicities in DLT definition if judged by the investigator to be possibly, probably or definitely related to study drug administration.
Time Frame
Up to 21 days after the first dose
Title
Phase Ia: Maximum tolerated dose (MTD)
Description
MTD is defined as the highest dose level at which no more than 1 in 6 participants experienced a DLT during the first cycle .
Time Frame
Up to 21 days after the first dose
Title
Phase Ib: Recommended Phase II Dose (RP2D)
Description
The RP2D is defined as the dose level chosen by the sponsor (in consultation with the investigators) for phase II study, based on safety, tolerability, efficacy, PK, and PD data collected during the dose escalation study of BL-B01D1
Time Frame
Up to 21 days after the first dose
Secondary Outcome Measure Information:
Title
Treatment-Emergent Adverse Event (TEAE)
Description
TEAE is defined as any unfavorable and unintended change in the structure, function, or chemistry of the body temporally emerging, or any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition during the treatment of BL-B01D1 . The type, frequency and severity of TEAE will be evaluated during the treatment of BL-B01D1 .
Time Frame
Up to approximately 24 months
Title
Cmax
Description
Maximum serum concentration (Cmax) of BL-B01D1 will be investigated.
Time Frame
Up to 21 days after the first dose
Title
Tmax
Description
Time to maximum serum concentration (Tmax) of BL-B01D1 will be investigated
Time Frame
Up to 21 days after the first dose
Title
T1/2
Description
Half-life (T1/2) of BL-B01D1 will be investigated
Time Frame
Up to 21 days after the first dose
Title
AUC0-t
Description
AUC0-t is defined as area under the serum concentration-time curve from time 0 to the time of the last measurable concentration.
Time Frame
Up to 21 days after the first dose
Title
CL (Clearance)
Description
CL in the serum of BL-B01D1 per unit of time will be investigated
Time Frame
Up to 21 days after the first dose
Title
Ctrough
Description
Ctough is defined as the lowest serum concentration of BL-B01D1 prior to the next dose will be administered
Time Frame
Up to 21 days after the first dose
Title
ADA (anti-drug antibody)
Description
Incidence and titer of ADA of BL-B01D1 will be evaluated
Time Frame
Up to approximately 24 months
Title
Nab (neutralizing antibody)
Description
Incidence and titer of Nab of BL-B01D1 will be evaluated.
Time Frame
Up to approximately 24 months
Title
Objective Response Rate (ORR)
Description
ORR is defined as the percentage of participants, who has a CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions). The percentage of participants who experiences a confirmed CR or PR is according to RECIST 1.1.
Time Frame
Up to approximately 24 months
Title
Disease Control Rate (DCR)
Description
The DCR is defined as the percentage of participants who has a CR, PR, or Stable Disease (SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease [PD: at least a 20% increase in the sum of diameters of target lesions and an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD]).
Time Frame
Up to approximately 24 months
Title
Duration of Response (DOR)
Description
The DOR for a responder is defined as the time from the participant's initial objective response to the first date of either disease progression or death, whichever occurs first.
Time Frame
Up to approximately 24 months
Title
Progression-free Survival (PFS)
Description
The PFS is defined as the time from the participant's first dose of BL-B01D1 to the first date of either disease progression or death, whichever occurs first.
Time Frame
Up to approximately 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants must sign the informed consent form voluntarily and follow the plan requirements. No gender limit. Age: ≥18 years old and ≤75 years old (phase Ia); ≥18 years old (phase Ib). Expected survival time ≥ 3 months. Patients with locally advanced or metastatic triple-negative breast cancer or other solid tumors who have been diagnosed histopathologically and/or cytologically as failing standard therapy, or who are not eligible for standard therapy at this stage, and who are inoperable. Agree to provide archived tumor tissue samples or fresh tissue samples from the primary tumor or metastatic tumor within 3 years (TROP2 protein expression in tumor pathological tissue to explore the correlation between TROP2 protein expression and BL-M02D1 validity index); If subjects are unable to provide tumor tissue samples, they will be admitted after evaluation by the investigator if other admission criteria are met. Participants must have at least one assessable lesion as defined by RECIST V1.1. Has an Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1 The toxicity of previous antitumor therapy was restored to ≤1 as defined by NCI-CTCAE v5.0 (except for asymptomatic laboratory abnormalities considered by the investigators, such as elevated ALP, hyperuricemia, and elevated blood glucose; Toxicities with no safety risk, such as hair loss, grade 2 peripheral neurotoxicity, were excluded). Has adequate organ function before registration, defined as: a) Bone marrow function: Absolute neutrophil count (ANC) ≥1.5×109/L, Platelet count ≥90×109/L, Hemoglobin ≥90 g/L; B) Hepatic function: Total bilirubin (TBIL≤1.5 ULN), AST and ALT ≤2.5 ULN for participants without liver metastasis, AST and ALT ≤5.0 ULN for liver metastases; c) Renal function: Creatinine (Cr) ≤1.5 ULN, or creatinine clearance (Ccr) ≥50 mL/min (according to the Cockcroft and Gault formula). Coagulation function: International normalized ratio (INR)≤1.5, and activated partial thromboplastin time (APTT)≤1.5ULN. Urinary protein ≤2+ or ≤1000mg/24h. For premenopausal women with childbearing potential, a pregnancy test must be taken within 7 days prior to the start of treatment. Serum or urine pregnancy must be negative and must be non-lactating. Adequate barrier contraceptive measures should be taken during the treatment and 6 months after the end of treatment for all participants (regardless of male or female). Exclusion Criteria: Patients screened for any of the following conditions will not be included in this study: Chemotherapy, biological therapy, immunotherapy, radical radiotherapy, major surgery, targeted therapy (including small molecule inhibitor of tyrosine kinase), and other anti-tumor therapy within 4 weeks or 5 half-lives (whichever is shorter) prior to the first administration; mitomycin and nitrosoureas treatment within 6 weeks prior to the first administration; oral fluorouracil-like drugs such as S-1, capecitabine, or palliative radiotherapy within 2weeks prior to the first administration. Prior treatment with ADC drugs targeting TROP2 or ADC drugs using camptothecin derivatives (topoisomerase I inhibitors) as toxins. Participants with history of severe heart disease, such as: symptomatic congestive heart failure (CHF) ≥ grade 2 (CTCAE 5.0), New York Heart Association (NYHA) ≥ grade 2 heart failure, history of transmural myocardial infarction, unstable angina pectoris etc. Participants with prolonged QT interval (male QTc> 450 msec or female QTc> 470 msec), complete left bundle branch block, III grade atrioventricular block. Active autoimmune diseases and inflammatory diseases, such as: systemic lupus erythematosus, psoriasis requiring systemic treatment, rheumatoid arthritis, inflammatory bowel disease and Hashimoto's thyroiditis, etc., except for type I diabetes, hypothyroidism that can be controlled only by alternative treatment, and skin diseases that do not require systemic treatment (such as vitiligo, psoriasis). The presence of a second primary tumor within 5 years prior to initial administration, except for radical basal cell carcinoma of the skin, squamous cell carcinoma of the skin, and/or radical resected carcinoma in situ. Screening for unstable thrombotic events such as deep vein thrombosis, arterial thrombosis and pulmonary embolism requiring therapeutic intervention within the first 6 months; Infusion device-related thrombosis is excluded; Unstable thrombotic events such as deep vein thrombosis, arterial thrombosis and pulmonary embolism requiring therapeutic intervention within 6 months prior to screening; Thrombus formation associated with infusion set is excluded. Symptoms of active central nervous system metastasis. However, patients with stable brain parenchymal metastases can be enrolled. Stable was defined as: a. The seizure-free state lasted for > 12 weeks with or without the use of antiepileptic drugs; b. Glucocorticoid use is not required; c. Consecutive MRI scans (at least 8 weeks between scans) showed stable imaging status. Patients with a history of allergy to recombinant humanized antibody or mouse chimeric antibody or to any excipients of BL-B01D1. Previous recipients of organ transplantation or allogeneic hematopoietic stem cell transplantation (Allo-HSCT). In previous adjuvant therapy with anthracyclines, the cumulative dose of anthracyclines was > 360 mg/m2. Positive human immunodeficiency virus antibody (HIVAb), active tuberculosis, active hepatitis B virus infection (HBV-DNA copy number > 103IU/ml) or active hepatitis C virus infection (HCV antibody positive and HCV-RNA > lower limit of detection). Active infections requiring systemic treatment, such as severe pneumonia, bacteremia, septicemia, etc. Participated in another clinical trial (calculated from the time of the last dose) within 4 weeks prior to the first dose. The other conditions of participation in this clinical trial were not considered appropriate by the investigators.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hai Zhu, PHD
Phone
+8613980051002
Email
zhuhai@baili-pharm.com
First Name & Middle Initial & Last Name or Official Title & Degree
Sa Xiao, PHD
Phone
+8615013238943
Email
xiaosa@baili-pharm.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lin Shen, PHD
Organizational Affiliation
Peking University Cancer Hospital & Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beijing Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100037
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lin Shen, PHD
Phone
+86-010-88196561
Email
doctorshenlin@sina.cn
First Name & Middle Initial & Last Name & Degree
Lin Shen, PHD
Facility Name
The First Affiliated Hospital of Nanchang University
City
Nanchang
State/Province
Jiangxi
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li Chen
Facility Name
Jinan Central Hospital
City
Jinan
State/Province
Shandong
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Meili Sun
First Name & Middle Initial & Last Name & Degree
Meili Sun
First Name & Middle Initial & Last Name & Degree
Qing Wen
Facility Name
West China Hospital, Sichuan University
City
Chengdu
State/Province
Sichuan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xuelei Ma
Facility Name
Tianjin Medical University General Hospital
City
Tianjin
State/Province
Tianjin
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Diansheng Zhong
Facility Name
Zhejiang Cancer Hospital
City
Hangzhou
State/Province
Zhejiang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ji Zhu

12. IPD Sharing Statement

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A Study of BL-B01D1 in Patients With Locally Advanced or Metastatic Gastrointestinal Tumor and Other Solid Tumor

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