eligibility_summary
Eligible: 2L metastatic or unresectable gastric/GEJ/esophageal adenocarcinoma progressed on 1L platinum/fluoropyrimidine ± immunotherapy, HER2+ excluded, controlled HBV/HCV/HIV allowed. Exclude: non-adenocarcinoma, major GI complications, significant CV/CNS disease or recent thrombosis, uncontrolled HTN, active CNS mets or infection, recent surgery or therapy/radiation/investigational/vaccine, anticoagulants/NSAIDs, prior TROP2/topo1 or anti-VEGF/VEGFR, severe hypersensitivity.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase 1/2 open-label, second-line study in advanced/metastatic gastroesophageal adenocarcinoma comparing: (A) Sacituzumab tirumotecan (MK-2870/SKB264, antibody-drug conjugate targeting TROP2 with a topoisomerase I inhibitor payload) plus paclitaxel vs (B) Ramucirumab (anti-VEGFR-2 monoclonal antibody) plus paclitaxel. Mechanisms: MK-2870 binds TROP2 on tumor cells, is internalized, and releases a topo I inhibitor to induce DNA damage and cell death, paclitaxel is a taxane that stabilizes microtubules and arrests mitosis, ramucirumab blocks VEGF ligand binding to VEGFR-2, inhibiting angiogenesis. Targets/pathways: TROP2-positive epithelial tumor cells, DNA damage/topoisomerase I, microtubule/mitotic machinery, VEGF–VEGFR-2 signaling in vascular endothelial cells.