Notes
SYSA-1801 = EO-3021 = CPO-102: fully-human anti-CLDN18.2 mAb, SITE-SPECIFIC MMAE ADC, DAR 2, cleavable PEG3-Val-Cit-PABC linker (cathepsin-B; PABC self-immolative; discrete PEG3 hydrophobicity masking; releases free MMAE). Developed by CSPC (CSPC Megalith); licensed to Elevation Oncology.
CLINICAL (two trials, same molecule):
(1) SYSA1801 China FIH Ph1 (NCT05009966; CSPC; ASCO 2023, J Clin Oncol 41:16_suppl 3016): n=33 (26 gastric/GEJ, 7 pancreatic), IV Q3W, escalation 0.5/1/2/3/4.5/6 mg/kg (modified 3+3), expansion at 2.0 & 2.5 mg/kg Q3W. Most-common TRAEs (>20%): nausea 42.4%, vomiting 36.4%, dry eye syndrome 21.2%, anaemia 21.2%. 2 DLTs (G3 nausea, G3 vomiting) at 3 mg/kg. Any-grade TRAE 75.8%, >=G3 24.2%. ADCdb lists this Phase-1 arm as terminated.
(2) EO-3021 global Ph1 (NCT05980416; Elevation): dose-escalation n=32 (26 gastric/GEJ), 1.0-2.9 mg/kg Q3W, RP2D 2.0 & 2.5 mg/kg Q3W; 4 DLTs at 2.9 mg/kg (G3 fatigue, G3 encephalopathy, appetite). Corroborates ocular signal: dry eye 29%, corneal disorders 21%. Explicitly NO neutropenia and NO peripheral neuropathy/hypoesthesia; no G4/5 TRAEs; <10% discontinued for toxicity. Early efficacy in CLDN18.2+ gastric/GEJ (ORR ~42.8%).
OCULAR ASSESSMENT: off-target corneal/ocular-surface auristatin toxicity (dry eye dominant; corneal disorders in the global trial). oae_any_pct set to 21.2 (max ocular PT, dry eye, in the named primary SYSA1801 China cohort); the global EO-3021 trial shows a somewhat higher dry-eye rate (29%) and adds corneal disorders (21%), both captured as corroborating rows.
EVIDENCE/TIER CAVEAT: All clinical (dosing, toxicity, ocular) data are conference-abstract/press-release level (Tier D) — no full peer-reviewed primary publication located. Composition/linker physchem (ADCdb) and payload physchem (standard MMAE) are Tier C. antibody_isotype left blank (fully human; specific isotype not disclosed). linker_attachment left blank (site-specific confirmed -> captured in conjugation_method; the reactive attachment chemistry is not explicitly disclosed). Hepatic / pulmonary-ILD / infusion-reaction AEs not reported in available sources -> left blank (not 0).