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Retlirafusp Alfa or Adebrelimab Plus SOX as Neoadjuvant Therapy for HER2-Negative Resectable Gastric or Gastroesophageal Junction Adenocarcinoma

3 novembre 2026 aggiornato da: Qun Zhao

A Randomized, Exploratory Phase II Study of Retlirafusp Alfa or Adebrelimab Combined With SOX as Neoadjuvant Therapy for HER2-Negative Resectable Gastric or Gastroesophageal Junction Adenocarcinoma

This multicenter, randomized, open-label, exploratory phase II study aims to evaluate the efficacy and safety of perioperative Retlirafusp Alfa plus SOX versus adebrelimab plus SOX in adult patients with previously untreated, HER2-negative, resectable locally advanced gastric or gastroesophageal junction adenocarcinoma (clinical stage II-III, AJCC 8th edition).

Approximately 98 participants will be randomized at a 1:1 ratio via stratified block randomization. Stratification factors include tumor location (gastric versus gastroesophageal junction) and PD-L1 combined positive score (CPS <1 versus CPS ≥1).

Participants will receive 3 preoperative cycles of assigned immunotherapy combined with SOX, followed by D2 radical gastrectomy performed 4-8 weeks after the last neoadjuvant cycle. Postoperatively, participants will receive 5 cycles of the same immunotherapy plus SOX, then up to 9 cycles of immunotherapy monotherapy, with a maximum of 17 total immunotherapy cycles.

The primary outcome measure is pathologic complete response (pCR) rate. Secondary outcome measures include R0 resection rate, event-free survival, disease-free survival, overall survival, surgical safety, adverse events, laboratory abnormalities, and treatment tolerability.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Stimato)

98

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria

  1. Voluntary signed written informed consent.

  2. Age ≥ 18 years.

  3. Histologically-confirmed gastric / gastroesophageal junction adenocarcinoma; Siewert II / III are eligible.

  4. Resectable clinical stage II-III (cT1-2N+M0, cT3-4aNanyM0, AJCC 8th edition) confirmed by CT / MRI.

  5. No prior anti-cancer therapy (surgery, radiotherapy, chemotherapy, targeted or immunotherapy).

  6. Investigator-assessable for R0 resection; planned curative surgery after neoadjuvant therapy.

  7. Able to swallow oral tablets.

  8. ECOG-PS 0-1.

  9. Available PD-L1 CPS result or 3-5 unstained tumor slides for testing (fresh or pre-randomization FFPE tissue acceptable).

  10. Estimated life expectancy ≥ 12 months.

  11. Adequate organ function (no transfusion / G-CSF in prior 14 d):

    • ANC ≥ 1.5 × 10⁹/L; platelets ≥ 80 × 10⁹/L; Hb ≥ 90 g/L
    • Total bilirubin < 1.5 × ULN; ALT/AST ≤ 2.5 × ULN
    • Serum Cr ≤ 1.5 × ULN or CrCl > 50 mL/min

  12. Women of child-bearing potential: negative serum pregnancy test ≤ 72 h pre-randomization; effective contraception (longer of 3 months post-last retlirafusp alfa / adebrelimab or 6 months post-chemotherapy). Fertile-partner males: surgical sterility or same contraception window; no sperm donation during study.

Exclusion Criteria

  1. Known HER2-positive tumor.
  2. Anticipated transthoracic surgical approach.
  3. Unresectable disease, surgical contraindication or refusal of surgery.
  4. Other malignancy within 5 years (exception: cured basal-cell skin, cervical / breast carcinoma-in-situ).
  5. Laparoscopy shows peritoneal metastasis, positive peritoneal cytology (CY1P0) or AJCC 8th T4b disease.
  6. Cardiac abnormalities: NYHA ≥ II heart failure or LVEF < 50 %; unstable angina; MI within 1 year; QTc prolongation (male>450 ms, female>470 ms); significant ECG abnormality / high-grade AV-block / PR>250 ms; risk factors for QTc prolongation.
  7. Gastrointestinal obstruction signs/symptoms within prior 6 months (except symptoms resolved by definitive surgery).
  8. Coagulopathy (INR>2.0, PT>16 s), bleeding diathesis or ongoing thrombolytic / anticoagulant therapy (prophylactic low-dose aspirin / LMWH allowed).
  9. Clinically-significant bleeding tendency within 3 months pre-randomization. Persistently positive fecal occult blood requires gastroscopy.
  10. GI perforation or fistula within prior 6 months.
  11. Arterial / venous thromboembolic event within prior 6 months (superficial phlebothrombosis excluded).
  12. Hereditary / acquired bleeding or thrombotic diathesis.
  13. Active ulcer, unhealed wound or fracture.
  14. Major vascular disease within prior 6 months.
  15. CTCAE>grade 2 severe infection within 4 weeks pre-randomization; active pulmonary inflammation; ongoing need for systemic antibiotics (≤48 h prophylactic IV antibiotics permitted).
  16. Active hepatitis B (HBsAg+ plus HBV-DNA ≥ 2000 IU/mL) or active hepatitis C.
  17. Congenital / acquired immunodeficiency including HIV infection.
  18. Prior or planned organ / allogeneic bone-marrow transplantation.
  19. Interstitial lung disease / pneumonitis (current or steroid-treated history); pulmonary fibrosis, pneumoconiosis, active tuberculosis or severe pulmonary impairment on screening CT.
  20. Active autoimmune disease or high-risk relapse history (exceptions: hormone-replaced hypothyroidism; controlled type 1 diabetes; stable vitiligo, psoriasis, resolved childhood asthma; asthma requiring bronchodilators is excluded).
  21. Systemic immunosuppressive corticosteroids (>10 mg prednisone-equivalent daily) within 7 days pre-randomization.
  22. Live-attenuated vaccine within 28 days pre-randomization or planned during-/within 60 days post-study-treatment.
  23. Hypersensitivity to any study drug or excipients.
  24. Investigational-drug clinical trial participation within prior 4 weeks.
  25. Pregnancy, lactation or planned pregnancy during study treatment.
  26. Investigator-judged other conditions interfering with study conduct or participant safety (substance abuse, severe psychiatric illness etc).

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Retlirafusp Alfa Plus SOX

Retlirafusp alfa plus SOX for 3 preoperative 21-day cycles, followed by D2 radical surgery, then retlirafusp alfa plus SOX for 5 postoperative cycles, followed by retlirafusp alfa alone for 9 cycles. Retlirafusp alfa may be given for a maximum of 17 cycles in total.
Droga: Retlirafusp Alfa Plus Chemotherapy

1800 mg administered by intravenous infusion on Day 1 of each 21-day cycle. Given with SOX for 3 preoperative and 5 postoperative cycles, then as monotherapy for 9 cycles, up to 17 cycles in total. When administered with oxaliplatin, retlirafusp alfa is infused first, with an interval of at least 30 minutes before oxaliplatin.
Sperimentale: Adebrelimab Plus SOX

Adebrelimab plus SOX for 3 preoperative 21-day cycles, followed by D2 radical surgery, then adebrelimab plus SOX for 5 postoperative cycles, followed by adebrelimab alone for 9 cycles. Adebrelimab may be given for a maximum of 17 cycles in total.
Droga: Adebrelimab Plus chemotherapy

1200 mg administered by intravenous infusion on Day 1 of each 21-day cycle. Given with SOX for 3 preoperative and 5 postoperative cycles, then as monotherapy for 9 cycles, up to 17 cycles in total. When administered with oxaliplatin, adebrelimab is infused first, with an interval of at least 30 minutes before oxaliplatin.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Pathologic Complete Response (pCR) Rate
Lasso di tempo: After D2 radical surgery (within 8 weeks after neoadjuvant completion)

Proportion of participants achieving TRG0 (CAP criteria): no viable tumor cells in primary tumor and regional lymph nodes after neoadjuvant therapy. Evaluated on surgical resection specimen.
After D2 radical surgery (within 8 weeks after neoadjuvant completion)

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
R0 Resection Rate
Lasso di tempo: At the time of surgery.

Proportion of subjects achieving R0 resection evaluated by surgical-pathology report.
At the time of surgery.
Event-Free Survival(EFS)
Lasso di tempo: Up to 5 years from randomization.

Time from randomization to disease progression, recurrence or death from any cause (whichever occurs first).
Up to 5 years from randomization.
Disease-Free Survival(DFS)
Lasso di tempo: Up to 5 years after surgery.

For post-surgery subjects without residual disease: time from surgery to disease recurrence or death from any cause.
Up to 5 years after surgery.
Overall Survival(OS)
Lasso di tempo: Up to 5-year follow-up post-randomization.

Time from randomization to death from any cause.
Up to 5-year follow-up post-randomization.
Safety and Tolerability
Lasso di tempo: From first study drug dose to safety-follow-up completion (90 days after last immunotherapy or 30 days post-chemotherapy/surgery, whichever occurs later).

Incidence, severity (CTCAE v6.0) of adverse events(AE), serious adverse events(SAE); surgical-related complications; treatment-related dose modification/discontinuation rate.
From first study drug dose to safety-follow-up completion (90 days after last immunotherapy or 30 days post-chemotherapy/surgery, whichever occurs later).

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Qun Zhao

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

30 novembre 2026

Completamento primario (Stimato)

30 marzo 2029

Completamento dello studio (Stimato)

30 dicembre 2031

Date di iscrizione allo studio

Primo inviato

3 novembre 2026

Primo inviato che soddisfa i criteri di controllo qualità

3 novembre 2026

Primo Inserito (Effettivo)

9 novembre 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

9 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

3 novembre 2026

Ultimo verificato

1 ottobre 2026

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • MA-GC-II-033

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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