Gastric Adenocarcinoma

P3, N=565, Active, not recruiting, Astellas Pharma Global Development, Inc. | Trial completion date: Mar 2026 --> Sep 2026

P2, N=258, Recruiting, Suzhou Suncadia Biopharmaceuticals Co., Ltd. | Active, not recruiting --> Recruiting | N=76 --> 258 | Trial completion date: Jul 2026 --> Dec 2027 | Trial primary completion date: Apr 2025 --> Dec 2027

In this real-world exploratory cohort, zolbetuximab-based chemotherapy achieved objective tumor responses consistent with prior clinical trials. Early serum albumin decline was not associated with inferior tumor response. These findings suggest that early albumin decline should not be interpreted as a surrogate marker of treatment failure or reduced antitumor efficacy but rather as a treatment-related physiological change. Prospective studies are warranted to clarify the clinical implications of albumin dynamics and optimize supportive care during anti-CLDN18.2 therapy.

Integrating molecular tools and standardized reassessment strategies can enhance HER2 testing reliability and enable more precise treatment strategies, with the potential to minimize HER2 resistance mechanisms. This review provides a practice-oriented guide on the interpretation and optimization of HER2 testing in gastric cancer, while providing insight into the underlying molecular mechanisms driving heterogeneity and resistance.

P2, N=224, Recruiting, AstraZeneca | Trial completion date: Dec 2026 --> Sep 2027 | Trial primary completion date: Dec 2025 --> Aug 2026

P1, N=18, Not yet recruiting, Beijing Immunochina Medical Science & Technology Co., Ltd.

In MKN-45 cells, merestinib increased the expression of pro-apoptotic proteins and decreased phosphorylation of c-Met, EGFR, IGF-1R, ERK, and AKT. These results indicate that combining merestinib with nab-paclitaxel may represent a promising therapeutic strategy to improve outcomes for patients with GAC.

P=N/A, N=640, Not yet recruiting, Xijing Hospital of Digestive Diseases

Notably, we identify specific microbial genera correlated with immune-related gene expression and immune checkpoint blockade responsiveness. These findings provide novel insights into the immune-microbiome axis in STAD and underscore the potential of integrative multi-omics approaches to enhance patient stratification and guide more effective immunotherapeutic strategies.

Cross-cohort analysis further revealed that despite favorable immunological features (higher TMB, neoantigen load, memory-activated CD4+ T cells, activated NK cells, mast cells, M1 macrophages and immune checkpoint expression), MSI-H gastric cancers have heterogeneous immunotherapy outcomes. Collectively, dMMR/MSI-H status alone is insufficient for outcome prediction, highlighting the need for individualized TIME evaluation in patients with gastric cancer receiving immunotherapy.

The patient was started on capecitabine and oxaliplatin in addition to trastuzumab with subsequent clinical and radiological improvement. Unresectable, metastatic HER2 positive conventional adenocarcinoma is being managed using platinum-fluoropyrimidine doublet therapy with anti-HER2 monoclonal antibody trastuzumab. This case report calls for aggressive IHC staining for prompt diagnosis where necessary as well as proper guidelines for management.

P3, N=507, Active, not recruiting, Astellas Pharma Global Development, Inc. | Trial completion date: Mar 2026 --> Sep 2026