Clinical Research Directory

D2 Gastrectomy With or Without Para-Aortic Lymph Node Dissection After Chemoimmunotherapy for Gastric Cancer

Some patients with gastric cancer have enlarged para-aortic lymph nodes, also called No. 16 lymph nodes, at diagnosis. After standard chemoimmunotherapy, these lymph nodes may shrink to less than 10 mm on imaging, but it is uncertain whether microscopic cancer remains and whether surgically removing these nodes improves disease control. This single-center randomized exploratory trial will enroll 32 patients whose suspicious No. 16a2 and/or No. 16b1 lymph nodes have regressed to less than 10 mm after 2 to 8 cycles of standard chemoimmunotherapy and who have no disease progression or new distant metastases. Participants will be assigned 1:1 to curative-intent gastrectomy with standard D2 lymphadenectomy either with or without para-aortic lymph node dissection. The main outcome is progression-free survival at 2 years after randomization.

Neoadjuvant SHR-A1811 ± Adebrelimab in GC/GEJ

This single-center, dual-cohort, exploratory phase II trial evaluates the efficacy and safety of trastuzumab rezetecan (SHR-A1811), an anti-HER2 antibody-drug conjugate (ADC), with or without the anti-PD-L1 antibody adebrelimab as neoadjuvant therapy in patients with locally advanced, resectable esophageal, gastric, or gastroesophageal junction (GEJ) adenocarcinoma. Approximately 62 patients aged ≥18 years with pathologically confirmed resectable disease (cT1b-2N+M0 or cT3-4NanyM0, American Joint Committee on Cancer \[AJCC\] 8th edition), HER2 intermediate-to-high expression (immunohistochemistry \[IHC\] 2+ or 3+), no prior systemic antitumor therapy for esophageal or gastric adenocarcinoma, and Eastern Cooperative Oncology Group (ECOG) performance status 0-1 are planned for enrollment. Eligible participants will be randomly assigned to receive either trastuzumab rezetecan monotherapy or trastuzumab rezetecan plus adebrelimab for 3 cycles (each cycle 21 days), followed by radical surgery. The primary endpoint is pathological complete response (pCR). Secondary endpoints include major pathological response (MPR), R0 resection rate, objective response rate (ORR), event-free survival (EFS), overall survival (OS), and safety. Exploratory objectives include biomarker analysis to identify predictors of response to HER2 ADC therapy with or without PD-L1 blockade.

Pembrolizumab and Palliative Radiation Therapy in Treating Patients With Metastatic Esophagus, Stomach, or Gastroesophageal Junction Cancer

This phase II trial studies how well pembrolizumab and palliative radiation therapy works in treating patients with esophagus, stomach, or gastroesophageal junction cancer that has spread to other parts of the body. Monoclonal antibodies, such as pembrolizumab, may interfere with the ability of tumor cells to grow and spread. Palliative radiation therapy, such as external beam radiation therapy, uses high energy beams to treat symptoms that are caused by tumors. Giving pembrolizumab together with palliative radiation therapy may work better in treating patients with esophagus, stomach, or gastroesophageal junction cancer that has spread to other parts of the body.

Lymph Node Dissection After Neoadjuvant Therapy for Gastric and EGJ Adenocarcinoma

This multicenter retrospective observational cohort study will evaluate approximately 2,000 adults with gastric or esophagogastric junction adenocarcinoma who received at least two cycles of neoadjuvant therapy followed by R0 gastrectomy with lymph node dissection. The study will estimate the frequency of pathological metastasis at individual lymph node stations according to the final preoperative imaging-based ycT and ycN categories and tumor location. The findings are intended to provide evidence for future prospective studies of risk-adapted reduction of perigastric lymph node dissection. No treatment is assigned by this study.

Lymph Node Metastasis Pattern After Neoadjuvant Chemoimmunotherapy in LAGC

The purpose of this observational study is to learn how stomach cancer that has spread to nearby lymph nodes responds to standard chemotherapy combined with immunotherapy given before surgery. In people with locally advanced gastric cancer, this pre-surgery treatment can shrink the tumor and clear cancer cells from some lymph nodes. However, it is not clear which groups of lymph nodes around the stomach still contain cancer cells after treatment. The study will also examine whether dense scarring (fibrosis) around the tumor is linked to a lower chance of cancer remaining in the lymph nodes. This information may help doctors in the future decide whether some lymph node groups can be safely left in place during surgery for people with severe scarring. Participants in this study will receive standard pre-surgery treatment with SOX chemotherapy (S-1 plus oxaliplatin) and a PD-1 inhibitor for at least 2 cycles. After treatment, they will undergo standard gastrectomy with D2 lymph node dissection, which is the routine surgical removal of the main lymph node groups around the stomach. During surgery, the surgeon will record the degree of scarring and difficulty in separating the tissues. Lymph nodes will be collected and labeled by station so that each group can be examined separately. The study will then describe how often cancer is found in each lymph node station after treatment and explore whether scarring is related to cancer remaining in the nodes. The study will also track surgical outcomes and follow participants for up to 3 years to assess cancer recurrence and survival. Approximately 103 participants will be enrolled. The study is expected to run from January 2027 through December 2029. Each participant will be followed for about 3 years after surgery, with clinic visits every 3 months for the first 2 years and every 6 months in the third year. This study does not assign participants to different treatments; all participants receive standard care, and the study only observes and records the results.

Study of ACC-1898 in Adult Participants With Advanced Solid Tumors

This is a research study of an experimental drug called ACC-1898. ACC-1898 is an oral tyrosine kinase inhibitor (TKI) that blocks several proteins kinases which may help cancer cells grow and spread. The purpose of this Phase 1 clinical trial is to find a safe dose of ACC-1898 and to understand how the body absorbs, distributes, and eliminates the drug (pharmacokinetics / PK). The study will also look for early signs that ACC-1898 may slow or shrink tumors and explore possible biological markers related to drug activity. Adults with advanced or metastatic solid tumors who have no remaining standard treatment options may take part. All participants will receive ACC-1898 tablets by mouth once daily in repeating 21-day cycles. Treatment may continue for up to two years if the cancer does not worsen and side effects are manageable. Safety information, laboratory results and imaging scans (CT or MRI) will be collected regularly. The study will first test different dose levels (dose-escalation phase) and may later expand enrollment in selected tumor types once a recommended dose is found.

A Vaccine (Ad5.F35-hGCC-PADRE) for the Treatment of Gastrointestinal Adenocarcinoma

The goal of this clinical trial is to learn whether the Ad5.F35-hGCC-PADRE vaccine is safe and can stimulate an immune response against gastrointestinal (GI) cancers in patients with pancreatic, colorectal, esophageal, gastric, or small bowel adenocarcinomas who have completed surgical resection and standard adjuvant therapy. An additional goal is to evaluate whether the vaccine may help eliminate minimal residual disease (MRD) in ctDNA-positive colon cancer patients. The main questions it aims to answer are: Is the Ad5.F35-hGCC-PADRE vaccine safe and tolerable at different dose levels? Does the vaccine induce GCC-specific T-cell immune responses in patients with GI malignancies? In ctDNA-positive colon cancer patients, can the vaccine promote ctDNA clearance as a marker of MRD elimination? The investigators will compare immune responses across different vaccine dose levels (10¹¹, 10¹², and 5 × 10¹² virus particles) to determine the optimal dose. Participants will: Receive the Ad5.F35-hGCC-PADRE vaccine by intramuscular injection. Be assigned to one of three dose levels during the dose-finding phase or receive a prespecified dose in the dose-expansion cohort. Undergo safety assessments, including monitoring for adverse events, injection-site reactions, and laboratory test abnormalities. Have blood samples collected to evaluate GCC-specific T-cell immune responses. For ctDNA-positive colon cancer patients, undergo ctDNA testing to assess clearance of minimal residual disease.

Feasibility Study of Middle Segmental Gastrectomy (MSG) for Gastric Cancer.

This multicenter, prospective, single-arm phase 2 clinical trial aims to evaluate the safety, feasibility, and clinical applicability of Middle Segmental Gastrectomy (MSG) for patients with gastric cancer * MSG is a function-preserving surgical technique that resects the middle portion of the stomach while preserving the pylorus and the upper stomach (cardia and fundus) to minimize common postoperative issues such as dumping syndrome and nutritional deficiencies The primary objective of the study is to determine the incidence of dumping syndrome at 1 year postoperatively (defined as a Sigstad score ≥ 7) and evaluate if it differs significantly from the 15.8% incidence reported for standard laparoscopic distal gastrectomy (LDG) in the KLASS 04 study . The study targets adult patients with mid- or high-body gastric adenocarcinoma with a tumor size of 4 cm or less at clinical stages cT1N0/1M0 or cT2N0/1M0 (well or moderately differentiated) . Secondary evaluations include monitoring postoperative reflux symptoms, changes in nutritional indicators (such as weight and hemoglobin), quality of life (QOL) using EORTC QLQ-C30 and STO22, and 3-year recurrence-free and overall survival rates.

A Study of KK2269 in Adult Participants With Solid Tumors

This is a first-in-human study of KK2269. Part 1 and Part 2 will be conducted as a multicenter, open-label, non-randomized, dose-escalation study. Participants with advanced or metastatic solid tumors for which no standard therapy is available will be enrolled in Part 1. In Part 1, the primary objective is to assess the safety and tolerability of KK2269. In Part 2, only participants with gastric adenocarcinoma, GEJ adenocarcinoma, esophageal adenocarcinoma, or NSCLC who have experienced at least one systemic therapy will be enrolled. In Part 2, the primary objective is to assess the safety and tolerability of KK2269 in combination with docetaxel and to determine the recommended dose(s) and dose interval(s) of KK2269 in combination with docetaxel for subsequent studies. In both Part 1 and Part 2, participants who refuse to undergo standard therapy are also eligible.

HIPEC Priming Followed by Serplulimab Plus SOX/XELOX in Locally Advanced Gastric Cancer

Patients with locally advanced gastric cancer (LAGC), particularly those with serosal invasion, remain at high risk of peritoneal recurrence despite standard perioperative treatment. Hyperthermic intraperitoneal chemotherapy (HIPEC) may eradicate free intraperitoneal tumor cells and microscopic peritoneal disease while potentially enhancing systemic anti-tumor immune activation. This is a prospective, single-center, single-arm exploratory study evaluating a HIPEC priming strategy followed by serplulimab-based neoadjuvant therapy in patients with locally advanced gastric cancer (cT3-4aN+M0). Eligible patients will undergo diagnostic laparoscopy confirming no visible peritoneal metastasis (P0) and negative peritoneal cytology (CY0), followed by docetaxel-based HIPEC. After recovery from HIPEC, patients will initially receive one cycle of serplulimab combined with fluoropyrimidine monotherapy (S-1 or capecitabine), followed by subsequent cycles of serplulimab combined with SOX/XELOX chemotherapy prior to radical gastrectomy. The primary endpoints are pathological complete response (pCR) rate and major pathological response (MPR) rate. Secondary endpoints include R0 resection rate, objective response rate (ORR), peritoneal recurrence-free survival (PRFS), overall survival (OS), and safety.

Early Recovery After Surgery Protocol in Improving Quality of Life in Participants With Stage 0-IIIC Gastric Cancer Undergoing Surgery

This phase II trial studies how well an early recovery after surgery protocol works in enhancing quality of life in participants with stage 0-IIIC gastric cancer undergoing surgery. The early recovery after surgery protocol may decrease pain and nausea, promote bowl function, decrease the number of days hospitalized, and improve a participant's ability to function normally after surgery.

Breath Research Narrow Validation for Gastrointestinal Cancer Detection

The investigators of this study are developing a simple breath test to help detect gastrointestinal (gut) cancers earlier, including cancers of the oesophagus (food pipe), stomach, pancreas, liver and bowel. These cancers often cause non-specific symptoms that are similar to benign conditions, making early diagnosis difficult. Delays between the onset of symptoms and referral for a diagnostic test such as an endoscopy or a scan, can allow the cancer to progress. The breath test detects small molecules called volatile organic compounds (VOCs) that are released in exhaled breath. Some of these VOCs are strongly associated with these cancers and may help identify high-risk patients who require urgent investigation. In practice, patients who come to their GP with concerning symptoms will be offered the breath test. If the test is positive, patients can be referred promptly for a diagnostic test, while those with a negative result can be reassured and offered re-testing if symptoms persist. Earlier diagnosis could improve access to curative treatment while reducing unnecessary invasive investigations. Previous studies have identified a panel of VOCs that appear to distinguish patients with gastrointestinal cancers from those without cancer. This study aims to confirm these findings in a new group of participants to determine whether the same biomarkers can be reliably identified. Participants will provide a breath sample, usually before a hospital procedure they are already scheduled to undergo, and complete a short questionnaire about their medical history and medications. Some participants will also be asked to drink a nutritional supplement before providing a second breath sample. The results will help determine whether the breath test is reliable enough for further clinical evaluation

A Study of ASP2138 Together With Chemotherapy and Pembrolizumab in Adults With Gastric Cancer

Claudin 18.2 or CLDN18.2 is a protein found on cells in the digestive system. It is also found in some tumors. Researchers are looking at ways to attack CLDN18.2 to help control tumors. ASP2138 is thought to bind to CLDN18.2 and a type of immune cell called a T cell. This "tells" the immune system to attack the tumor. ASP2138 is a potential treatment for people with gastric cancer (also known as stomach cancer) or gastroesophageal junction cancer (GEJ cancer). GEJ is where the tube that carries food (esophagus) joins the stomach. This study is for people with gastric or GEJ cancer that has spread nearby (locally advanced) and is not removable by surgery (unresectable), or has spread to other parts of the body (metastatic). It is for those whose cancer is human epidermal growth factor receptor 2 (HER2)-negative and CLDN18.2-positive. HER2-negative means the cancer does not have extra HER2 protein, so medicines that target HER2 do not work and are therefore not used. CLDN18.2-positive means people have a certain amount of CLDN18.2 proteins on their cancer cells. In this study, researchers want to learn if ASP2138 given together with standard treatments (chemotherapy and pembrolizumab) help people with HER2-negative and CLDN18.2-positive gastric or GEJ cancer. The main aim is to learn how long people who are given ASP2138 with chemotherapy and pembrolizumab live without their cancer getting worse, compared with placebo given with chemotherapy with or without pembrolizumab, and if they live for longer. Placebo looks like the study treatment but does not have any medicine in it. The main aim of this study is to check how well ASP2138 works when given together with chemotherapy and pembrolizumab compared with placebo plus chemotherapy with or without pembrolizumab. People aged 18 years or older with locally advanced unresectable or metastatic gastric or GEJ cancer can take part. Their tumor should be HER2-negative and CLDN18.2-positive. The study doctors will check people for any health conditions that can exclude them from taking part, interfere with the study procedures, or pose an unacceptable risk. This is a double-blind study. That means the people and the study doctors will not know who will receive which treatment. People will be assigned to one of 2 treatment groups by chance: Group A: People will receive ASP2138 along with chemotherapy and pembrolizumab. Group B: People will receive placebo along with chemotherapy, with or without pembrolizumab. People will keep receiving treatment until their cancer gets worse, they have medical problems that require stopping treatment, or a study rule says they must stop. There will be regular safety checks. People will continue to have scans of their tumor until their cancer becomes worse.

Different Cycles of Neoadjuvant PD-1 Blockades + Chemotherapy for Advanced Gastric Cancer

The goal of this observational study is to analyze the impact of different durations of neoadjuvant PD-1 inhibitor combined with chemotherapy on tumor regression and safety in patients with advanced gastric cancer. The main questions it aims to answer are: * Does the duration of neoadjuvant treatment influence tumor regression grading (TRG)? * How does treatment duration affect perioperative safety and clinical outcomes? Participants who have previously undergone neoadjuvant PD-1 inhibitor combined with chemotherapy followed by surgery as part of their routine medical care will have their clinical data retrospectively reviewed and analyzed.

Phase 1/2 Study of BHB810 in Advanced Gastric and GEJ Adenocarcinoma

This study is looking at how safe BHB810 is in adults with gastric and gastroesophageal adenocarcinoma (GEJ). The purpose of this study is also to look at: how well the study drug works, how the study drug moves into, through, and out of the body, and how your body reacts to the study drug. Participants will get an IV infusion of BHB810 every 2 weeks while on study treatment.

Efficacy of Tirellizumab Combined With Oral, Intravenous and Abdominal Chemotherapy in Peritoneal Metastatic Gastric/Gastroesophageal Junction Adenocarcinoma

For peritoneal metastatic gastric/gastroesophageal junction adenocarcinoma (cT3-4NanyM1), PD-1 antibody combined with chemotherapy and hyperthermic intraperitoneal chemotherapy (HIPEC) can downstage tumor stage, increase the conversion resection rate, and may improve the long-term survival. Tislelizumab, an anti-PD-1 antibody, has recently been proved in the first- and second-line standard treatment for advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma.In the subgroup analysis of RATIONALE-305 trial, tislelizumab also showed good efficacy in gastric/gastroesophageal junction adenocarcinoma patients with peritoneal metastasis. Combination of tirellizumab,SOX and HIPEC for peritoneal metastatic gastric/gastroesophageal junction adenocarcinoma could be a novel therapeutic strategy to increase response rate and therapeutic efficacy. This study is a monocenter, single-arm phase 2 clinical trial to evaluate tolerability, safety and efficacy of perioperative tirellizumab in combination with SOX and HIPEC in peritoneal metastatic gastric/gastroesophageal junction adenocarcinoma.

A Study of Anti-PD-1 and LAG-3 Bispecific Antibody(AK129) Combined With Chemotherapy With or Without Cadonilimab in the First-line Treatment of Unresectable Locally Advanced or Metastatic G/ GEJ Adenocarcinoma

Phase Ib/II clinical study of AK129 combined with chemotherapy with or without cadonilimab in first-line treatment of advanced HER2 negative gastric cancer or gastroesophageal junction adenocarcinoma

Conversion Therapy Plus Surgery and Radiotherapy for Retroperitoneal Nodal Metastases in Gastric Cancer

This is a randomized, controlled, multicenter phase II clinical trial evaluating the efficacy and safety of conversion therapy combined with radical gastrectomy and adjuvant radiotherapy targeting para-aortic (station 16) lymph nodes in patients with gastric adenocarcinoma and isolated station 16 nodal metastases. Eligible participants must have no evidence of peritoneal dissemination, visceral metastases, or non-regional lymphatic spread. Based on PD-L1 combined positive score (CPS), patients in the experimental arm will receive systemic therapy with SOX (S-1 plus oxaliplatin) with or without a PD-1 inhibitor, followed by D2 gastrectomy and postoperative adjuvant SOX chemotherapy, then intensity-modulated radiotherapy (IMRT) to the para-aortic region. The control arm will receive standard chemotherapy with CAPEOX or SOX, with or without immunotherapy, according to CPS status. The primary endpoint is progression-free survival (PFS), with secondary endpoints including overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. This study aims to explore whether the addition of locoregional treatment to systemic therapy improves long-term outcomes in this select patient population.

CT Radiomics and Deep Learning-Based Non-Invasive Model for Tracing Primary Sites of Adenocarcinoma Liver Metastases: Automatic Differentiation of Multiple Primary Digestive Tumors

This is a retrospective observational study. Liver metastasis occurs frequently in digestive-system cancers. Identification of the primary tumor source of liver metastasis may pose clinical challenges. Biopsy is an invasive procedure associated with potential sampling errors. This study aims to develop and validate a non-invasive artificial-intelligence model based on contrast-enhanced CT images. The model integrates CT radiomics and deep learning to automatically determine the primary origin of adenocarcinoma liver metastases, including gastric adenocarcinoma, colorectal adenocarcinoma, biliary/gallbladder adenocarcinoma, and pancreatic ductal adenocarcinoma. The investigators will retrieve historical medical records and de-identified abdominal contrast-enhanced CT images from patients diagnosed at West China Hospital, Sichuan University between January 2015 and August 2026. No new intervention or treatment will be administered to participants in this study.

A Study of Pembrolizumab With Trastuzumab and Chemotherapy in People With Esophagogastric Cancer

The purpose of this study to find out whether adding trastuzumab and pembrolizumab to standard chemotherapy is an effective treatment for resectable HER2+ esophagogastric cancer.

Neoadjuvant Iparomlimab and Tuvonralimab With Nab-P-SOX in Locally Advanced Gastric or Gastroesophageal Junction Cancer

This is a single-center, single-arm, phase 2 clinical study testing a new neoadjuvant (pre-surgery) treatment for patients with locally advanced gastric cancer or gastroesophageal junction (GEJ) cancer. The treatment combines two parts: (1) a novel bispecific immunotherapy drug, iparomlimab and tuvonralimab (Qibain®) , which helps the immune system attack cancer cells by blocking the PD-1 and CTLA-4 pathways; and (2) a standard chemotherapy regimen called nab-P-SOX, made up of nab-paclitaxel, oxaliplatin, and S-1. About 28 adults (aged 18-75) with previously untreated, HER2-negative, locally advanced gastric or GEJ adenocarcinoma (clinical stage cT3-4aN+M0) will receive this combination before their planned surgery. The main goal is to see how well the tumor shrinks, measured by the objective response rate (RECIST v1.1). Secondary goals include the rate of complete response in the removed tumor tissue (pathological complete response), how often the cancer is removed with clear margins (R0 resection), survival outcomes, and the safety of the treatment. All participants will be closely followed to track both benefits and side effects. The study is sponsored by Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, with funding and the study drug provided by Qilu Pharmaceutical Co., Ltd.

Phase I-II, FIH, TROP2 ADC, Advanced Unresectable/Metastatic Solid Tumors, Refractory to Standard Therapies (KL264-01)

A Phase I-II, First-in-Human Study of SKB264 (Sac-TMT; MK-2870) in Patients with Locally Advanced Unresectable/Metastatic Solid Tumors who are refractory to Available Standard Therapies. Patient must have historically documented, incurable, locally advanced or metastatic cancer that are refractory to standard therapies of one of the following types: 1. Triple negative breast cancer 2. Epithelial ovarian cancer 3. Non-small cell lung cancer 4. Gastric adenocarcinoma/Gastroesophageal junction adenocarcinoma 5. Small cell lung cancer 6. HR+/ HER2-breast cancer 7. Head and neck squamous cell carcinoma 8. Endometrial carcinoma 9. Urothelial carcinoma 10. Cervical cancer

A Study of TRK-950 When Used in Combination With Ramucirumab and Paclitaxel in Patients With Gastric Cancer

This study will assess the efficacy, safety, optimal dose and ADA and NAbs development of TRK-950 at two separate dose levels in combination with ramucirumab and paclitaxel (RAM+PTX) as compared with RAM + PTX treatment alone in participants with gastric or gastro-esophageal junction (GEJ) adenocarcinoma.

Evaluating Novel Therapies in ctDNA Positive GI Cancers

This study is a non-randomized, open-label, multi-cohort, multi-site, pilot feasibility therapeutic trial. The study will enroll 20 patients across 4 cohorts (CRC, gastric, PDAC, and HCC/intra-hepatic-/extra-hepatic-, gall bladder adenocarcinomas) diagnosed with histologically confirmed GI cancers. These patients will have already completed all Standard of Care (SOC) treatments (including neoadjuvant, surgery, local therapies, and/or adjuvant therapy as applicable), as defined by the treating primary physician or research team, with curative intent but have a positive SignateraTM tumor-informed ctDNA test and NED radiographically by standard imaging within 28 days prior to enrollment and within 1 year of completing all curative-intent therapy. All patients will be treated with intravenous (IV) atezolizumab 1200 mg IV and bevacizumab 15 mg/kg on Day 1 of 21-day cycles until disease recurrence, ctDNA POD, unacceptable toxicity, or subject withdrawal of consent with a maximum 12 month total duration of study therapy. Atezolizumab and bevacizumab drug will be provided.