Exploratory Study on the Application of Molecular Residual Disease (MRD) in Postoperative Treatment of Gastric Cancer

Launched by CANCER INSTITUTE AND HOSPITAL, CHINESE ACADEMY OF MEDICAL SCIENCES · Jun 14, 2025

Keywords

ClinConnect Summary

This clinical trial is exploring a new way to improve treatment after surgery for stomach cancer, specifically a type called gastric adenocarcinoma. Even after surgery and standard chemotherapy, many patients still face the cancer coming back, especially in the lining of the abdomen (called the peritoneum). This study uses a special test to detect tiny amounts of leftover cancer cells in the fluid collected from the abdomen during surgery. Depending on the test results, doctors will decide whether to add a type of chemotherapy delivered directly into the abdomen to help prevent the cancer from spreading there.

The trial is open to adults between 18 and 75 years old who have a confirmed diagnosis of locally advanced stomach cancer and are healthy enough for surgery and chemotherapy. If your test shows no leftover cancer cells in the abdominal fluid, you will be closely observed to see if cancer returns in other parts of the body, using a blood test to help predict this. Participants can expect regular follow-ups and testing after surgery to monitor their condition. This study aims to find better ways to tailor treatment after surgery to reduce the chances of cancer coming back and improve overall outcomes.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Histologically confirmed adenocarcinoma, mucinous adenocarcinoma, or signet ring cell carcinoma of the stomach or gastroesophageal junction (GEJ).
• • Clinical stage cT4NanyM0, deemed suitable for radical resection.
• • Age between 18 and 75 years.
• • ECOG performance status of 0 or 1.
• • No prior neoadjuvant therapy and strong patient/family preference for primary surgery.
• * Adequate organ function defined as:
• • Absolute neutrophil count (ANC) \> 1.5 x 10⁹/L (or \> 1500/µL)；Hemoglobin (Hb) \> 90 g/L；Platelet count (PLT) \> 100 x 10⁹/L (or \> 100,000/µL)；Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) \< 2.5 x Upper Limit of Normal (ULN)；Total bilirubin (TBIL) \< 1.5 x ULN；Serum creatinine (Cr) \< 1.0 x ULN
• • Good compliance and willingness to undergo long-term follow-up.
• • Provision of signed written informed consent.
• Exclusion Criteria:
• • Pathological specimens containing \>10% of other histological components (e.g., squamous cell carcinoma, neuroendocrine carcinoma, etc.).
• • Uncontrolled gastrointestinal obstruction or recurrent bleeding.
• • Inability to swallow oral medications.
• • Active infection requiring systemic therapy.
• • Moderate to severe cirrhosis due to any cause.
• • Cardiac function classified as NYHA class \> I.
• • History of myocardial infarction, unstable angina, stroke, or uncontrolled arrhythmia.
• • Anticipated inability to tolerate postoperative adjuvant chemotherapy.
• • Concurrent medical conditions that contraindicate chemotherapy.
• • Pregnancy or lactation; history of psychiatric illness; poor compliance.