Gastric cancer, or stomach cancer, affects roughly 26,000 people in the United States each year. Treatment typically involves surgery, chemotherapy, and in some cases radiation. Recent approvals of targeted drugs and immunotherapy have expanded options, especially for advanced disease, but outcomes remain better when the cancer is caught early.
What's actually going on in research
Trials are testing checkpoint inhibitors like pembrolizumab and nivolumab in earlier stages of disease, evaluating HER2-targeted drugs for HER2-positive tumors, and studying claudin 18.2-targeted therapies that recently gained approval in other countries. Researchers are also exploring perioperative chemotherapy regimens, personalized medicine based on tumor genetics, and treatments for gastric cancer with specific mutations like MSI-high status.
Claudin 18.2-targeted therapy
Zolbetuximab, a drug targeting the claudin 18.2 protein on tumor cells, was FDA-approved in 2024 for advanced gastric cancer. Trials are now testing it in earlier stages and in combination with other treatments.
Perioperative immunotherapy
Studies are testing checkpoint inhibitors given before and after surgery to shrink tumors and prevent recurrence. Early data suggest this approach may improve outcomes for people with resectable gastric cancer.
HER2-targeted combinations
For the 15-20% of gastric cancers with HER2 overexpression, trials are testing trastuzumab with newer drugs like tucatinib and antibody-drug conjugates. These combinations aim to overcome resistance that often develops.
What to know before you search
Eligibility typically depends on disease stage, prior treatments, HER2 and biomarker status, and whether the cancer can be surgically removed.
What types of trials are currently open
- Treatment trials — Testing new chemotherapy combinations, targeted drugs, or immunotherapy regimens for advanced gastric cancer. Many compare new approaches to standard platinum-based chemotherapy.
- Perioperative trials — Testing treatments given before and after surgery to improve the chances of cure. These often involve chemotherapy with or without immunotherapy.
- Biomarker-driven trials — Matching people to treatments based on tumor features like HER2 status, MSI-high status, or PD-L1 expression. These trials test whether personalized approaches improve outcomes.
- Maintenance therapy trials — Testing whether continuing treatment after initial chemotherapy can keep the cancer under control longer. Immunotherapy is often used in this setting.
- Prevention trials — Studying ways to prevent gastric cancer in people at high risk, including those with precancerous changes or H. pylori infection.
Recently added Gastric Cancer trials
Total Neoadjuvant Immunotherapy Plus Chemotherapy for Locally Advanced Gastric or Gastroesophageal Junction Adenocarcinoma
This study is for people with locally advanced adenocarcinoma of the stomach or of the junction between the stomach and esophagus (gastroesophageal junction adenocarcinoma) that can be removed by surgery. Serplulimab (an anti-PD-1 antibody) has been approved in China for use around the time of surgery in this type of cancer. This study will evaluate a treatment approach called total neoadjuvant therapy, in which all planned immunotherapy plus chemotherapy is given before surgery. About 42 patients will take part at 2 hospitals in China. All participants will receive serplulimab plus the SOX regimen (oxaliplatin and S-1) before surgery, followed by surgical removal of the tumor. All treatment is given before surgery. After surgery, participants will not receive additional chemotherapy or immunotherapy. They will be followed regularly with examinations and tests to check for any return of the cancer. Researchers will collect tumor tissue, blood, and stool samples before, during, and after treatment. These samples will be used to study how the tumor and the immune system change during treatment, including the immune cells inside the tumor, the tumor's genetic features, and traces of tumor DNA in the blood. Researchers will also grow mini-tumors (organoids) from patients' tumor tissue in the laboratory to test how the tumor responds to drugs. The study will measure how completely the tumor shrinks or disappears after treatment, the side effects participants experience, and how long participants remain free of cancer after surgery. Participants will be followed regularly after treatment ends.
A Phase I Dose Escalation Study of CG-7321 Monotherapy or Combination Therapy in Advanced Solid Tumors
This is a Phase I, open-label, multi-center study to evaluate the safety, tolerability, pharmacokinetics (PK), and preliminary efficacy of CG-7321 capsules as monotherapy or in combination with fulvestrant or letrozole in subjects with advanced solid tumors. The study consists of: * Part Ia (Monotherapy): Dose escalation (accelerated titration followed by 3+3 design) from 2mg to 50mg twice daily (BID), plus dose expansion cohorts in advanced solid tumors including HR+/HER2- breast cancer, ovarian cancer, gastric cancer, and other tumor types. * Part Ib (Combination Therapy): Dose escalation of CG-7321 combined with fulvestrant or letrozole in HR+/HER2- advanced breast cancer.
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