eligibility_summary
Adults ≥18 with resected HER2+ (IHC3+ or 2+/ISH+) gastric/GEJ/lower esophageal (Siewert I) adenocarcinoma, stage I–III, ctDNA+ by Signatera post-op, ≥6 wks neoadjuvant chemo, R0, recovered, no prior HER2 therapy, no mets, ECOG 0–1, LVEF ≥50%, adequate labs, contraception per protocol. Exclude: uncontrolled illness/infection, recent MI/CHF/arrhythmia/QTc↑, ILD/pulmonary disease, other recent cancers, drainable effusions, unresolved tox, hypersensitivity, pregnancy/breastfeeding, live vaccine <30 d, active HIV/HBV/HCV, likely noncompliance.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
NCT05965479 (DECIPHER): Single‑arm Phase II UK trial testing trastuzumab deruxtecan (T‑DXd, Enhertu)—an antibody‑drug conjugate (type: anti‑HER2 IgG1 monoclonal antibody linked to deruxtecan, a topoisomerase I inhibitor)—as ctDNA‑guided adjuvant therapy in HER2‑positive, ctDNA‑positive gastro‑oesophageal adenocarcinoma post‑chemo‑surgery. Mechanism: trastuzumab binds HER2/ERBB2, blocks HER2 signaling and mediates ADCC, the conjugate is internalized, releasing DXd to inhibit topoisomerase I, causing DNA damage, membrane‑permeable payload enables bystander killing. Targets: HER2‑overexpressing micrometastatic tumor cells (minimal residual disease detected via ctDNA), HER2/ERBB pathway, and DNA replication/repair via topo I inhibition.