eligibility_summary
Eligible: adv/unresectable/met gastric/GEJ/esoph adenoca, measurable RECIST1.1, progressed after ≥2 regimens, any HER2(HER2+ trastuzumab), adequate organs, ECOG 0–1, TROP2 testing, AEs ≤G1, swallow oral meds, controlled HIV, HBV/HCV VL undetectable. Exclude: severe ocular dz, ≥G2 neuropathy, IBD, major CV/CVA or effusions, prior TROP2 ADC/topo I, recent systemic tx/RT/vax/IND, strong/mod CYP3A4 drugs, other cancer, CNS mets, infection, KS/MCD, HBV+HCV coinf, recent major surgery, hypersens, pneumonitis/ILD.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
NCT06356311 tests sacituzumab tirumotecan (MK-2870/SKB264) vs Treatment of Physician’s Choice in 3L+ advanced/metastatic gastroesophageal adenocarcinoma. MK-2870 is a TROP2-directed antibody-drug conjugate (ADC) that binds TROP2 on tumor cells and delivers a topoisomerase I–inhibitor payload via a cleavable linker, causing DNA damage and apoptosis (potential bystander effect). Comparator options/mechanisms: trifluridine–tipiracil (oral antimetabolite, trifluridine incorporates into DNA, tipiracil inhibits thymidine phosphorylase to boost exposure), irinotecan (IV topoisomerase I inhibitor prodrug), paclitaxel and docetaxel (IV taxane microtubule stabilizers). Targets/pathways: TROP2+ epithelial cancer cells, topoisomerase I–mediated DNA repair, DNA replication, microtubule dynamics.