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Total Neoadjuvant Immunotherapy Plus Chemotherapy for Locally Advanced Gastric or Gastroesophageal Junction Adenocarcinoma (TNICE-1)

6 november 2026 bijgewerkt door: Beijing Tsinghua Chang Gung Hospital

A Multicenter, Prospective Study of Total Neoadjuvant Immunotherapy Combined With Chemotherapy in Patients With Locally Advanced Gastric or Gastroesophageal Junction Adenocarcinoma: The TNICE-1 Study

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.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

This is a multicenter, prospective clinical study of total neoadjuvant immunotherapy combined with chemotherapy in patients with locally advanced, resectable gastric or gastroesophageal junction adenocarcinoma. All participants receive a uniform regimen of the anti-PD-1 antibody serplulimab combined with the SOX regimen(oxaliplatin and S-1) administered entirely before surgery (total neoadjuvant approach), followed by radical gastrectomy. Unlike approved perioperative strategies in which immunotherapy is continued after surgery as maintenance monotherapy, this study administers the entire planned course of immunochemotherapy before surgery and does not administer any postoperative systemic therapy. The total neoadjuvant approach is intended to maximize treatment delivery while patients are treatment-naive and physiologically fit, to avoid postoperative complications delaying or preventing adjuvant therapy, and to allow pathological response at surgery to serve as an in vivo readout of treatment efficacy.

The study is embedded in a comprehensive translational research program. Longitudinal biospecimens (tumor tissue, peripheral blood, ascites if present, and stool) are collected at predefined time points. Exploratory research includes multiplex immunohistochemistry (mIHC), spatial transcriptomics, single-cell RNA sequencing, whole-exome sequencing, circulating tumor DNA (ctDNA)-based minimal residual disease (MRD) monitoring, patient-derived organoid (PDO) drug screening, gut microbiome profiling, and development of an artificial-intelligence-based model to predict treatment response. Because no postoperative therapy is administered, postoperative ctDNA-based MRD assessment is used for risk stratification and to inform individualized surveillance strategies. These analyses aim to identify biomarkers of response and resistance to total neoadjuvant immunochemotherapy and to support individualized perioperative treatment strategies.

Studietype

Ingrijpend

Inschrijving (Geschat)

42

Fase

  • Fase 2

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

  • Naam: Qiong Wu
  • Telefoonnummer: +86010-56111011

Studie Locaties

    • Beijing Municipality
      • Beijing, Beijing Municipality, China
        • Werving
        • Beijing Tsinghua Changgung Hospital
        • Contact:
    • Guangdong
      • Guangzhou, Guangdong, China
        • Nog niet aan het werven
        • Nanfang Hospital of Southern Medical University
        • Contact:

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Able to understand the study and provide signed informed consent (ICF)
  • Histologically confirmed adenocarcinoma of the stomach or gastroesophageal junction, clinically staged as stage II/III disease (cT1-2N+M0 or cT3-4aNxM0) based on contrast-enhanced CT/MRI
  • Willing to provide archived tumor tissue or undergo biopsy for central laboratory testing of PD-L1, EBV, and MSI/dMMR status
  • Tumor with PD-L1 CPS >=5, or MSI-H/dMMR, or EBV positivity
  • Male or female, age >=18 years
  • ECOG performance status 0-1, with no surgical contraindications
  • Life expectancy >=6 months
  • Laboratory values within 7 days prior to enrollment: absolute neutrophil count (ANC) >=1.5 x 10^9/L; platelet count >=100 x 10^9/L; hemoglobin >=90 g/L; serum albumin >=30 g/L; total bilirubin <=1.5 x ULN; AST and ALT <=2.5 x ULN (<=5 x ULN in subjects with liver metastases); creatinine <=1.5 x ULN or creatinine clearance >=50 mL/min; INR and aPTT <=1.5 x ULN (applicable only to subjects not receiving anticoagulant therapy; subjects receiving anticoagulants must be on a stable dose)
  • Good compliance and willingness to cooperate with protocol-required examinations and specimen collection (tissue, blood, stool, and saliva samples)
  • Women of childbearing potential must agree to use contraception from the time of ICF signing until at least 5 months after the last dose of study treatment or accompanying chemotherapy, and must not breastfeed; men must agree to use contraception from the first dose of study drug until at least 7 months after the last dose

Exclusion Criteria:

  • Known allergy to serplulimab or its excipients, oxaliplatin, or components of tegafur/gimeracil/oteracil potassium (S-1)
  • Prior or concurrent other malignancy (except adequately treated basal cell carcinoma of the skin or carcinoma in situ of the uterine cervix)
  • Uncontrolled pericardial effusion, pleural effusion, ascites, or gastrointestinal bleeding within 2 weeks prior to enrollment
  • Body weight loss >20% within 2 weeks prior to enrollment
  • Unable to take oral medications
  • Prior chemotherapy, radiotherapy, targeted therapy, immunotherapy, or surgery for gastric cancer
  • Prior treatment with anti-PD-1, anti-PD-L1, anti-PD-L2, or anti-CTLA-4 antibodies
  • HER2-positive tumor confirmed by central laboratory testing (IHC 3+, or IHC 2+ with positive FISH/ISH)
  • Comorbidities requiring long-term immunosuppressive therapy, or systemic or local corticosteroids at immunosuppressive doses
  • Vaccination with any anti-infectious vaccine within 4 weeks prior to enrollment
  • Uncontrolled diabetes mellitus, hypertension, or other systemic diseases
  • Currently receiving or requiring anticoagulant therapy (low-dose aspirin antiplatelet therapy allowed)
  • Any active autoimmune disease or history of autoimmune disease
  • Active tuberculosis, currently receiving anti-tuberculosis treatment, or anti-tuberculosis treatment within 1 year prior to screening
  • Confirmed interstitial pneumonitis, non-infectious pneumonitis, pulmonary fibrosis, or history of acute lung disease
  • Any contraindication to oxaliplatin or S-1
  • Pregnant or breastfeeding women
  • Active hepatitis (HBV DNA >=10^4 copies/mL or positive HCV RNA)
  • Positive HIV antibody or human T-lymphotropic virus type 1 (HTLV-1) antibody
  • Any other clinically significant disease or condition that, in the investigator's judgment, may affect protocol compliance or render the subject unsuitable for participation

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Serplulimab + SOX

All participants receive total neoadjuvant therapy consisting of serplulimab plus the SOX regimen administered entirely before surgery, followed by radical gastrectomy. No postoperative systemic therapy is administered.

Anti-PD-1 monoclonal antibody administered as neoadjuvant immunotherapy in combination with the SOX regimen, given entirely before surgery (total neoadjuvant approach).

Combination chemotherapy of oxaliplatin plus S-1 (tegafur/gimeracil/oteracil), administered before surgery in combination with serplulimab.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Pathological Complete Response (pCR) Rate
Tijdsspanne: At surgery (approximately 6 months after start of study treatment)

Proportion of participants achieving pathological complete response, defined as no viable tumor cells in the resected primary tumor and lymph nodes (ypT0 ypN0), assessed by local pathology review of the surgical specimen.

At surgery (approximately 6 months after start of study treatment)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Medewerkers

Onderzoekers

  • Hoofdonderzoeker: Guoxin Li, Department of General Surgery, Cancer Center, Beijing Tsinghua Changgung Hospital

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

5 augustus 2026

Primaire voltooiing (Geschat)

30 december 2027

Studie voltooiing (Geschat)

30 december 2028

Studieregistratiedata

Eerst ingediend

6 november 2026

Eerst ingediend dat voldeed aan de QC-criteria

6 november 2026

Eerst geplaatst (Werkelijk)

12 november 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

12 november 2026

Laatste update ingediend die voldeed aan QC-criteria

6 november 2026

Laatst geverifieerd

1 november 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • 26768-4-01

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

JA

Beschrijving IPD-plan

Individual participant data (IPD) that underlie the results reported in this study, after deidentification (text, tables, figures, and appendices), will be shared. Deidentified IPD will be made available beginning 9 months after primary completion of the study and will remain available for 5 years. Data will be shared with qualified investigators worldwide who submit a methodologically sound proposal for secondary analyses, such as individual participant data meta-analysis; proposals may be submitted at any time while the data are available. Data will be provided upon reasonable request approved by the study team, together with a signed data access agreement, through secure data transfer. The study protocol and statistical analysis plan will also be available upon request under the same terms. No re-identification of participants is permitted.

IPD-tijdsbestek voor delen

eidentified individual participant data and supporting information (study protocol and statistical analysis plan) will be available beginning 9 months after the primary completion date of the study and will remain available for 5 years thereafter.

IPD-toegangscriteria voor delen

Qualified investigators affiliated with academic or research institutions may request access to the deidentified individual participant data that underlie the results reported in this study, as well as the study protocol and statistical analysis plan. Requests must include a methodologically sound research proposal and a signed data access agreement, and will be reviewed by the study team. Approved data will be provided through secure data transfer. Re-identification of study participants is not permitted. Requests may be submitted at any time while the data are available.

IPD delen Ondersteunend informatietype

  • LEERPROTOCOOL
  • SAP

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .