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
Share your medical records and outcomes in a bowel cancer registry
This cohort study is divided into two parts: Part A: Registry Cohort All patients with non-metastatic, MMRd/MSI-H colorectal cancers (and other gastrointestinal cancers for exploratory analysis) who have signed the general research consent will be included in a prospective registry. This includes patients who undergo primary surgical resection (+/- neoadjuvant/adjuvant therapy) or following immunotherapy, regardless of response. Part A is a multicenter observational registry with both prospective and retrospective enrolment. Prospective enrolment includes eligible patients entered into the registry after activation of the study at the respective participating site. Retrospective enrolment includes eligible patients diagnosed on or after 1 January 2024 whose clinical data were generated prior to registry activation. Both prospectively and retrospectively enrolled patients contribute to the registry analyses. Part B: Active Surveillance Cohort (Surveillance Study) A subset of patients from Part A who achieve a complete or near-complete response to ICI therapy, wish to avoid surgery, and are deemed appropriate for non-operative management by a multidisciplinary tumor board are offered inclusion in a phase II surveillance study (Part B). Patients enrolled in Part B will be analysed for the primary endpoint.
Predicting Efficacy of Preoperative Immunotherapy in Advanced Gastric Cancer
This study intends to employ FAPI and Grazytracer PET/CT to predict the therapeutic response to preoperative immunotherapy-based combination regimens in patients with advanced gastric cancer. The study is expected to provide an early, non-invasive predictive tool for immunotherapy-based combination therapy in gastric cancer, offer molecular imaging-based evidence for treatment stratification, and facilitate the optimization of precision therapeutic strategies.
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