This study is a single-arm, open, multicenter, non-randomized phase Ib/II clinical study evaluating the efficacy and safety of BL-M07D1 for injection in patients with HER2-expressing recurrent or metastatic gynecologic malignancies.

Inclusion Criteria:

1. Sign the informed consent form voluntarily and follow the protocol requirements;
2. Female;
3. Age: ≥18 years old and ≤75 years old;
4. Expected survival time ≥3 months;
5. patients with recurrent or metastatic HER2-positive/low-expression gynecologic malignancies who have failed or are intolerant to standard treatment or who currently have no standard treatment;
6. The histopathology of gynecological malignant tumors should meet the following conditions: HER2 positive; Low expression of HER2;
7. Consent to provide archived tumor tissue samples or fresh tissue samples of primary or metastatic lesions within 2 years;
8. At least one measurable lesion meeting the RECIST v1.1 definition was required;
9. ECOG score 0 or 1;
10. The toxicity of previous antineoplastic therapy has returned to ≤ grade 1 defined by NCI-CTCAE v5.0;
11. No severe cardiac dysfunction, left ventricular ejection fraction ≥50%;
12. No blood transfusion, use of any cell growth factors and/or platelet-raising drugs were allowed within 14 days before screening, and the organ function level had to be acceptable;
13. Urinary protein ≤2+ or ≤1000mg/24h;
14. albumin ≥30 g/L;
15. Women who are likely to give birth must have negative serum/urine pregnancy within 7 days before treatment and must be non-lactating; All enrolled patients should have adequate contraception throughout the treatment cycle and for 6 months after the end of treatment.

Exclusion Criteria:

1. had received anti-tumor therapy before the first dose; Mitomycin and nitrosoureas; Oral fluorouracils; Palliative radiotherapy; Anti-tumor traditional Chinese medicine or Chinese patent medicine;
2. had received prior ADC drug therapy with camptothecin derivative (topoisomerase I inhibitor) as toxin;
3. had a history of serious cardiovascular and cerebrovascular diseases;
4. active autoimmune or inflammatory diseases;
5. Patients with other malignant tumors within 5 years before the first administration, except cured skin squamous cell carcinoma, basal cell carcinoma, superficial bladder cancer and prostate/cervix/breast cancer in situ;
6. Unstable thrombotic events such as deep vein thrombosis, arterial thrombosis, and pulmonary embolism requiring medical intervention within 6 months before screening;
7. patients with massive or symptomatic effusions or poorly controlled effusions;
8. Hypertension poorly controlled by antihypertensive drugs (systolic blood pressure > 150 mmHg or diastolic blood pressure > 100 mmHg);
9. Current interstitial lung disease, drug-induced interstitial pneumonia, radiation pneumonitis requiring steroid therapy, or a history of these diseases;
10. patients with central nervous system (CNS) metastases and/or carcinomatous meningitis (meningeal metastases);
11. patients with a history of allergy to recombinant humanized antibody or human-mouse chimeric antibody or to any ingredient of BL-M07D1;
12. patients received previous organ transplantation or allogeneic hematopoietic stem cell transplantation (Allo-HSCT);
13. HIVAb positive, active tuberculosis, active hepatitis B virus infection, or active hepatitis C virus infection;
14. active infections requiring systemic therapy, such as severe pneumonia, bacteremia, sepsis, etc.;
15. had participated in another clinical trial within 4 weeks before the first dose;
16. pregnant or lactating women;
17. The investigator did not consider it appropriate to apply other criteria for participation in the trial.