eligibility_summary
Eligibility: Adults (≥18) with HER2+ (IHC3+ or 2+/FISH+) unresectable/metastatic gastroesophageal adenocarcinoma, progressed after trastuzumab+platinum, RECIST measurable/evaluable, fit for paclitaxel+ramucirumab, ECOG 0–1, life expectancy ≥12 wks, adequate organs, EF≥50%, provide tumor tissue/blood, imaging ≤28 days, consent, follow-up, contraception (during + 7 mo). Exclude: active/uncontrolled illness, unresolved ≥G2 toxicity, concurrent trials, uncured cancers, noncompliance, controlled HIV/HBV/HCV allowed.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Randomized phase II in HER2+ unresectable/metastatic gastroesophageal adenocarcinoma post‑trastuzumab. Arms: paclitaxel + ramucirumab vs. same plus zanidatamab. Drug types/mechanisms: Paclitaxel (taxane cytotoxic) stabilizes microtubules, halting mitosis and inducing apoptosis in proliferating tumor cells. Ramucirumab (human IgG1 monoclonal antibody) blocks VEGFR‑2 on endothelial cells, inhibiting VEGF‑driven angiogenesis and tumor blood supply. Zanidatamab (bispecific/biparatopic anti‑HER2 IgG1) binds two HER2 epitopes (trastuzumab‑ and pertuzumab‑like), blocks HER2 dimerization/signaling (PI3K/AKT, MAPK), promotes internalization/downregulation, and mediates ADCC. Targets: HER2‑overexpressing tumor cells, microtubule apparatus, and VEGFR2‑mediated tumor angiogenesis.