eligibility_summary
Adults 18–75 with locally advanced gastric/GEJ adenocarcinoma (AJCC 8th: T3–4aN+M0 or T4aNanyM0), HER2 IHC 2+/3+, ECOG 0–1, life ≥6 mo, adequate organs, surgery candidate, no prior systemic therapy. Exclude: other active malignancy, bleeding risk/recent transfusion, unable to take oral meds, recent trial/investigational drug, systemic tx <2 yrs, allogeneic transplant (except cornea), allergy, ≥G2 neuropathy, HIV, active HBV/HCV, live vaccine <30 d, pregnant/breastfeeding, severe/uncontrolled disease.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase II, single-arm neoadjuvant/adjuvant trial in HER2-overexpressing locally advanced gastric/GEJ adenocarcinoma tests: 1) Disitamab vedotin (RC48), an anti-HER2 antibody–drug conjugate (ADC) delivering MMAE, a microtubule inhibitor, to HER2+ tumor cells. 2) Adebrelimab, an anti–PD-L1 monoclonal antibody (immune checkpoint inhibitor) that blocks PD-1/PD-L1 to restore T-cell antitumor activity. 3) Apatinib, an oral small-molecule VEGFR-2 tyrosine kinase inhibitor that suppresses VEGF-driven angiogenesis. 4) S-1 (tegafur/gimeracil/oteracil), an oral fluoropyrimidine chemotherapy, tegafur → 5-FU inhibits thymidylate synthase and DNA synthesis, gimeracil boosts 5-FU, oteracil reduces GI toxicity. Targets/pathways: HER2 on tumor cells, microtubules in dividing cancer cells, PD-1/PD-L1 axis on tumor/immune cells to activate cytotoxic T cells, VEGF/VEGFR-2 in tumor vasculature, thymidylate synthase/nucleotide synthesis in rapidly proliferating cells.