eligibility_summary
Adults (≥19y, >30 kg) with HER2+ unresectable locally advanced gastric/GEJ adenocarcinoma, no distant/peritoneal mets, ECOG 0–1, measurable disease, LVEF ≥50%, adequate organ function. Exclude: DPD deficiency, uncontrolled illness or unresolved ≥G2 AEs, transplant, autoimmune/ILD, active HBV/HCV/TB or uncontrolled HIV, major cardiac disease or QTc ≥470 ms, pregnancy/breastfeeding, hypersensitivity, recent immunosuppression or live vaccines, Rilvegostomig GI/skin autoimmunity.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase II perioperative trial in HER2+ locally advanced unresectable gastric cancer. Interventions: 1) Trastuzumab deruxtecan (T-DXd, Enhertu) – antibody-drug conjugate targeting HER2, internalization releases a topoisomerase I inhibitor (DXd) causing DNA damage and bystander killing. 2) Capecitabine (Xeloda) – oral 5-FU prodrug, antimetabolite that inhibits thymidylate synthase, impairing DNA/RNA synthesis. 3) Rilvegostomig (AZD2936) – bispecific immune checkpoint monoclonal antibody that blocks PD-1 and TIGIT to restore antitumor T-cell activity. Cells/pathways targeted: HER2-overexpressing gastric tumor cells, topoisomerase I and DNA replication, fluoropyrimidine/TS pathway, PD-1/PD-L1 and TIGIT/CD155 (CD226 axis) on exhausted CD8+ T cells and NK cells to enhance cytotoxic immune responses.