Phase 2 sacituzumab tirumotecan (MK-2870) TROP2 ADC ± pembrolizumab PD-1 mAb in OCCC

This randomized Phase 2 study at Tufts Medical Center tests sacituzumab tirumotecan (MK-2870), a TROP2-directed antibody-drug conjugate that delivers a belotecan-derived topoisomerase I–inhibitor payload, either alone or combined with pembrolizumab, a PD-1–blocking monoclonal antibody. The goal is to estimate anti-tumor activity (commonly overall response rate) and characterize safety in relapsed/refractory ovarian clear cell carcinoma (including clear cell cancers arising from ovary, fallopian tube, or peritoneum, and inclusive of endometriosis-associated disease) after prior anti–PD-1 therapy. Commercially, it’s an “IO-after-IO” strategy paired with a next-generation TROP2 ADC—potentially relevant because OCCC is relatively chemoresistant and has limited proven post–checkpoint inhibitor options. Today’s care for relapsed OCCC is typically sequential systemic therapy (platinum when sensitive; otherwise non-platinum chemo such as weekly paclitaxel, liposomal doxorubicin, or gemcitabine), sometimes with bevacizumab, and clinical trials; this trial asks whether a TROP2 ADC, with or without PD-1 re-challenge, can improve outcomes in a difficult, previously IO-exposed setting.