This study is a clinical study to explore the efficacy and safety of BL-B01D1+PD-1/PD-L1 monoclonal antibody in patients with advanced biliary tract cancer.

Inclusion Criteria:

1. Sign the informed consent form voluntarily and follow the protocol requirements;
2. Gender is not limited;
3. Age ≥18 years old and ≤75 years old;
4. Expected survival time ≥3 months;
5. Patients with advanced biliary tract cancer confirmed by histology or cytology;
6. Patients must provide a documented tumor tissue specimen of the primary or metastatic tumor within 3 years for PD-L1 testing and other testing;
7. At least one measurable lesion meeting the RECIST v1.1 definition was required;
8. ECOG score 0-1;
9. The toxicity of previous antineoplastic therapy has returned to ≤ grade 1 as defined by NCI-CTCAE v5.0;
10. No severe cardiac dysfunction, left ventricular ejection fraction ≥50%;
11. Organ function level must meet the requirements;
12. Coagulation function: international normalized ratio (INR) ≤1.5×ULN, and activated partial thromboplastin time (APTT) ≤1.5×ULN;
13. Urinary protein ≤2+ or ≤1000mg/24h;
14. For premenopausal women of childbearing potential, a pregnancy test must be performed within 7 days before starting treatment, a serum or urine pregnancy test must be negative, and the patient must not be lactating; All enrolled patients should take adequate barrier contraception during the entire treatment cycle and for 6 months after the end of treatment.

Exclusion Criteria:

1. Patients with active central nervous system metastases;
2. Who had participated in any other clinical trial within 4 weeks before the trial dose;
3. Received anti-tumor therapy such as chemotherapy, radiotherapy and biological therapy within 4 weeks before the first use of study drug;
4. Had undergone major surgery (investigator-defined) within 4 weeks before the first dose;
5. Had received immunotherapy and developed grade ≥3 irAE or grade ≥2 immune-related myocarditis;
6. Use of immunomodulatory drugs within 14 days before the first dose of study drug;
7. Systemic corticosteroids or immunosuppressive agents were required within 2 weeks before the study administration;
8. Pulmonary disease grade ≥3 according to NCI-CTCAE v5.0; A history of ILD/pulmonary inflammation requiring steroid treatment;
9. Severe systemic infection occurred within 4 weeks before screening;
10. Patients at risk for active autoimmune disease or with a history of autoimmune disease;
11. Other malignant tumors within 5 years before the first dose;
12. Human immunodeficiency virus antibody positive, active tuberculosis, active hepatitis B virus infection or hepatitis C virus infection;
13. Poorly controlled hypertension by two antihypertensive drugs with different mechanisms;
14. Diabetic patients with poor glycemic control;
15. Had a history of severe cardiovascular and cerebrovascular diseases;
16. Previous history of autologous or allogeneic stem cell, bone marrow or organ transplantation;
17. Subjects with clinically significant bleeding or significant bleeding tendency within the preceding 4 weeks were screened;
18. Patients with massive or symptomatic effusions or poorly controlled effusions;
19. Imaging examination showed that the tumor had invaded or wrapped around the chest, neck, pharynx and other large arteries or invaded the pericardium and heart;
20. Unstable thrombotic events requiring therapeutic intervention within 6 months before screening;
21. Prior treatment with an ADC drug with a topoisomerase I inhibitor as a toxin;
22. Patients with a history of allergy to recombinant humanized antibodies or to any of the excipients of the trial drug;
23. The cumulative dose of anthracyclines > 360 mg/m2 in previous (new) adjuvant therapy;
24. Pregnant or lactating women;
25. Who have a history of psychotropic drug abuse and cannot quit or have mental disorders;
26. The investigator did not consider it appropriate to apply other criteria for participation in the trial.