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Predicting Efficacy of Preoperative Immunotherapy in Advanced Gastric Cancer

11. september 2026 oppdatert av: Ruijin Hospital

Predicting Efficacy of Preoperative Immunotherapy Combined Treatment 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.

Studieoversikt

Detaljert beskrivelse

This prospective study intends to employ FAPI and Grazytracer PET/CT to predict the therapeutic response to preoperative immunotherapy-based combination regimens (neoadjuvant therapy or conversion therapy) in patients with advanced gastric cancer. Enrolled patients will undergo paired FAPI PET/CT and Grazytracer PET/CT examinations at baseline and at a predefined follow-up time point (either after one cycle or at treatment completion). With the tumor regression grade (TRG) serving as the reference standard, the study will investigate the correlation between PET/CT-derived parameters and therapeutic response, as well as the predictive performance of these parameters for prognosis. This study is expected to provide an early, non-invasive predictive tool for preoperative immunotherapy-based combination therapy in advanced gastric cancer, thereby avoiding ineffective treatment and the associated healthcare costs and patient burden; moreover, it is anticipated to offer molecular imaging-based evidence for treatment stratification in gastric cancer immunotherapy, ultimately facilitating the optimization of precision therapeutic strategies.

Studietype

Observasjonsmessig

Registrering (Antatt)

120

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

      • Shanghai, Kina
        • Rekruttering
        • Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

Outpatients or inpatients who meet the eligibility criteria will be referred by the Department of Gastrointestinal Surgery at our hospital for enrollment in this clinical study.

Beskrivelse

Inclusion Criteria:

  1. Age: 18 years ≤ age ≤ 80 years.
  2. The subject must have histopathologically confirmed gastric adenocarcinoma via gastroscopic biopsy.
  3. Clinical stage: cT3-4aN0-3M0 (according to the 8th edition UICC gastric cancer cTNM) with surgically resectable locally advanced gastric cancer, or cT3-4bN1-3M1 (non-peritoneal metastasis) with advanced gastric cancer.
  4. Eastern Cooperative Oncology Group (ECOG) performance status score: 0-1.
  5. Hematology: white blood cell count > 4 × 10⁹/L, neutrophil count > 2 × 10⁹/L, hemoglobin > 90 g/L, and platelet count > 100 × 10⁹/L.
  6. Cardiac function: left ventricular ejection fraction (LVEF) > 50%.
  7. Liver function: total bilirubin < 1.5 × the upper limit of normal (ULN); aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 1.5 × ULN.
  8. Renal function: serum creatinine ≤ 1.5 × ULN, or estimated glomerular filtration rate (eGFR) > 60 mL/min.
  9. The subject must agree to participate in this clinical trial and sign the informed consent form.
  10. The subject must demonstrate good compliance, commit to adhering to the study procedures, and cooperate with the full implementation of the study process.
  11. The subject must have no plans for pregnancy within 6 months.

Exclusion Criteria:

  1. Patients with other primary malignancies within 5 years, with the exception of adequately treated basal cell carcinoma and squamous cell carcinoma of the skin.
  2. Patients with known hypersensitivity or contraindications to chemotherapeutic or immunotherapeutic agents.
  3. Patients with severe concomitant diseases that, in the investigator's judgment, render the patient unsuitable for enrollment in this clinical study, including but not limited to severe cardiopulmonary insufficiency, severe bone marrow suppression, and severe hepatic or renal dysfunction.
  4. Patients with severe psychiatric disorders, or those who are mentally impaired and unable to cooperate with the required study assessments.
  5. Women who are pregnant, possibly pregnant, or breastfeeding.
  6. Patients with poor compliance.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Intervensjon / Behandling
Early Efficacy Evaluation Group for Neoadjuvant Immunotherapy-Based Combination Therapy
Patients receiving neoadjuvant immunotherapy-based combination therapy - paired FAPI and Grazytracer PET/CT at baseline and after 1 cycle.
A FAP-targeted radiotracer for PET/CT imaging; administered intravenously.
A Granzyme B-targeted radiotracer for PET/CT imaging; administered intravenously.
Efficacy Evaluation Group for Neoadjuvant Immunotherapy-Based Combination Therapy
Patients receiving neoadjuvant immunotherapy-based combination therapy - paired FAPI and Grazytracer PET/CT at baseline and at treatment completion.
A FAP-targeted radiotracer for PET/CT imaging; administered intravenously.
A Granzyme B-targeted radiotracer for PET/CT imaging; administered intravenously.
Early Efficacy Evaluation Group for Conversion Immunotherapy-Based Combination Therapy
Patients receiving conversion immunotherapy-based combination therapy - paired FAPI and Grazytracer PET/CT at baseline and after 1 cycle.
A FAP-targeted radiotracer for PET/CT imaging; administered intravenously.
A Granzyme B-targeted radiotracer for PET/CT imaging; administered intravenously.
Efficacy Evaluation Group for Conversion Immunotherapy-Based Combination Therapy
Patients receiving conversion immunotherapy-based combination therapy - paired FAPI and Grazytracer PET/CT at baseline and at treatment completion.
A FAP-targeted radiotracer for PET/CT imaging; administered intravenously.
A Granzyme B-targeted radiotracer for PET/CT imaging; administered intravenously.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Predictive performance of FAPI and Grazytracer PET/CT
Tidsramme: an average of 3 years
Predictive performance assessed by AUC, with sensitivity, specificity, PPV, NPV, and accuracy at optimal cutoff, using tumor regression grade (TRG) as the reference standard.
an average of 3 years

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Association of PET Parameters with TRG, 5-year DFS, and OS
Tidsramme: Through study completion and up to 5 years post-treatment
Quantitative PET parameters (SUVmax, SUVpeak, TBR, and others) will be correlated with TRG, 5-year DFS, and OS.
Through study completion and up to 5 years post-treatment
Association of Tumor Microenvironment Biomarkers (FAP and Granzyme B Expression) with TRG, 5-Year DFS, and OS
Tidsramme: Through study completion and up to 5 years post-treatment
FAP and Granzyme B expression levels in tumor tissue will be correlated with TRG, 5-year DFS, and OS
Through study completion and up to 5 years post-treatment

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

17. juni 2025

Primær fullføring (Antatt)

31. mai 2033

Studiet fullført (Antatt)

31. mai 2033

Datoer for studieregistrering

Først innsendt

11. september 2026

Først innsendt som oppfylte QC-kriteriene

11. september 2026

Først lagt ut (Faktiske)

17. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

17. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

11. september 2026

Sist bekreftet

1. mars 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 2025 CER 330

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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