Gastric / Stomach Cancer Clinical Trials

About Gastric / Stomach Cancer trials

Gastric and gastroesophageal junction (GEJ) cancer trials sort largely by several molecular axes that together determine which trials apply. HER2 (ERBB2) amplification is present in 15-20% of gastric cancer and remains the most established targeted axis, with anti-HER2 antibodies and ADCs across multiple lines. PD-L1 (CD274) status, measured by combined positive score (CPS), gates eligibility for front-line IO + chemo combinations. MMR / MSI status identifies the small subgroup (5-10%) with high response rates to immunotherapy and gates dedicated IO trials. FGFR2 amplification in roughly 5-10% of gastric cancer drives a separate trial set, particularly around anti-FGFR2b antibodies. MET amplification is rare but actionable for MET-targeted trials. BRCA2 mutations enable PARP inhibitor eligibility in the small HRD subset. KRAS mutations are uncommon in gastric cancer compared to colorectal or pancreatic cancer, but emerging KRAS trials may apply when present.

Gastric cancer trial activity organizes around HER2 status, IO eligibility, and treatment line. Front-line metastatic trials test additions to or alternatives to chemo + IO (the post-CheckMate 649 standard for PD-L1 high disease) and chemo + IO + trastuzumab (the post-KEYNOTE-811 standard for HER2-positive disease). HER2-targeted trials in later lines test ADCs (especially T-DXd combinations), bispecifics, and novel ADC payloads. FGFR2-amplified trials test anti-FGFR2b antibodies and small-molecule FGFR inhibitors. Perioperative trials test FLOT or FLOT-IO combinations for resectable locally advanced disease, with adjuvant IO addition under study. MMR-deficient trials test IO monotherapy in earlier and later lines. Second-line trials beyond targeted populations test antiangiogenic combinations, ADCs, and IO rechallenge. Anti-claudin 18.2 trials are an active emerging space for patients whose tumors test positive (a marker not in this panel but increasingly screened at trial sites).

Gastric cancer trial screening typically checks histology, HER2 and PD-L1 status, and prior therapy. Histology and tumor location: gastric proper vs gastroesophageal junction adenocarcinoma vs squamous esophageal (which has separate trials). HER2 status by IHC and FISH (3+ or amplified gates HER2-targeted trials). PD-L1 CPS with cutoffs that vary by trial design (CPS ≥1, ≥5, ≥10). MMR / MSI status for IO trials. Prior chemotherapy regimens and lines, especially platinum and taxane exposure. Prior IO exposure for IO-rechallenge or post-IO trials. Prior anti-HER2 agent exposure (and which agent) for HER2-targeted trials. Performance status, with most trials accepting ECOG 0-1. Adequate nutrition and weight loss criteria can be specific to gastric trials because of disease impact on swallowing, intake, and cachexia.

Biomarkers tested in Gastric / Stomach Cancer trials

These are the molecular markers most commonly required or evaluated in Gastric / Stomach Cancer eligibility criteria. OncoMatch extracts them from each trial's protocol and matches them against your test results.