Gastric Cancer Clinical Trials (May 2026): 543 Recruiting Interventional Studies

Last updated: May 6, 2026

Current Clinical Trial Landscape

Active research areas in 2026:

CLDN18.2-targeted therapy — zolbetuximab combinations now first-line for CLDN18.2-positive disease; multiple ADCs (AZD0901, IBI343, JS107) in Phase 3
HER2+ disease — trastuzumab + chemo + pembrolizumab established (KEYNOTE-811); next-gen HER2 ADCs (T-DXd, disitamab vedotin, BL-M07D1) being tested earlier
Perioperative immunotherapy — adding IO to FLOT or SOX before and after surgery (MATTERHORN-FLOT-style trials)
MSI-H / dMMR — IO monotherapy or IO+IO combinations testing whether chemo can be omitted
PD-L1 × VEGF bispecifics (pumitamig, ivonescimab-class) in first-line + chemo

Standard of care (2026): Locally advanced: perioperative FLOT (or SOX in Asia) ± immunotherapy. Metastatic 1L HER2+: trastuzumab + chemo + pembrolizumab. Metastatic 1L HER2− CLDN18.2+: zolbetuximab + chemo. Metastatic 1L HER2− CLDN18.2− PD-L1 CPS≥5: nivolumab + FOLFOX or pembrolizumab + chemo. MSI-H/dMMR: pembrolizumab. Later lines: trastuzumab deruxtecan (HER2+), ramucirumab + paclitaxel, TAS-102.

Recruiting Trials by Treatment Setting

Perioperative (Locally Advanced, Resectable)

Adding immunotherapy to perioperative chemo (FLOT or SOX) — a major active area in 2026:

IO + perioperative chemo:
- NCT07023315 — Cadonilimab + SOX as perioperative treatment (Phase 3)
- NCT06949033 — Cadonilimab + perioperative SOX for diffuse/mixed gastric (Phase 3)
- NCT06925243 — Neoadjuvant apatinib + sintilimab + perioperative SOX vs sintilimab+SOX (Phase 3)
- NCT06028737 — Total neoadjuvant FLOT in locally advanced gastric/GEJ (Phase 2/3)
Adjuvant after surgery:
- NCT07366528 — Adjuvant oxaliplatin + S-1 vs docetaxel + S-1 for Stage III gastric (Phase 3)
- NCT05482516 — Novel therapies in ctDNA-positive GI cancers (Phase 3)

Metastatic / Advanced — First-Line

First-line trials are organized by biomarker. The right trial depends on your HER2, CLDN18.2, MSI, and PD-L1 status:

HER2-positive:
- NCT06731478 — Trastuzumab deruxtecan + chemo + pembrolizumab + trastuzumab in 1L HER2+ metastatic (Phase 3)
- NCT06532006 — HLX22 + trastuzumab + chemo in HER2+ gastric (Phase 3)
- NCT07315750 — Disitamab vedotin + trastuzumab + tislelizumab vs chemo (Phase 3)
- NCT06764875 — Rilvegostomig + fluoropyrimidine + trastuzumab deruxtecan (Phase 3)
CLDN18.2-positive:
- NCT06901531 — Zolbetuximab + pembrolizumab + chemo in CLDN18.2+ gastric/GEJ (Phase 3)
- NCT06346392 — AZD0901 (CLDN18.2 ADC) vs investigator's choice (Phase 3)
- NCT06238843 — IBI343 (CLDN18.2 ADC) monotherapy vs investigator's choice (Phase 3)
- NCT07103668 — CLDN18.2-positive unresectable locally advanced gastric (Phase 3)
MSI-H / dMMR:
- NCT06346197 — Combination immune checkpoint inhibitors in MSI/dMMR esogastric adenocarcinoma (Phase 3)
HER2− / Other 1L combinations:
- NCT07221149 — Pumitamig (PD-L1 × VEGF bispecific) + chemo in esophageal/GEJ/gastric (Phase 3)
- NCT06203600 — Adding nivolumab to standard treatment for advanced stomach/esophageal (Phase 3)
- NCT06793917 — Tislelizumab + FOLFOX vs POF in locally advanced gastric (Phase 3)
- NCT04342910 — Camrelizumab + apatinib in gastric cancer (Phase 3)

Metastatic — Second-Line and Beyond

After first-line failure — ADCs and novel agents are the main active area:

HER2-targeted ADCs (HER2+):
- NCT07118527 — SHR-A1811 + chemo + adebrelimab in previously treated gastric (Phase 3)
- NCT07152405 — BL-M07D1 vs chemo in HER2+ gastric (Phase 3)
CLDN18.2-targeted (CLDN18.2+):
- NCT07284134 — JS107 vs investigator's choice in 2L+ CLDN18.2+ advanced gastric (Phase 3)
Other novel agents:
- NCT07431281 — Sonesitatug vedotin + capecitabine ± rilvegostomig in GEJ/gastric (Phase 3)
- NCT07270991 — Trifluridine/tipiracil + fruquintinib vs trifluridine/tipiracil alone (Phase 3)
- NCT07392892 — PF-08634404 + chemo in esophageal/GEJ/gastric (Phase 2/3)

Peritoneal Disease

Trials specifically for peritoneal carcinomatosis — a common pattern of gastric cancer spread:

- NCT05871099 — Laparoscopic gastrectomy + D2 lymphadenectomy + HIPEC (Phase 3)
- NCT07304271 — Intraperitoneal paclitaxel + systemic therapy vs systemic alone (Phase 3)
- NCT05303714 — PIPAC in multimodal therapy for oligometastatic peritoneal gastric (Phase 3)
- NCT07001748 — Intra-abdominal paclitaxel + chemo (Phase 2/3)

Showing selected notable trials. View all 543 recruiting interventional trials on ClinicalTrials.gov.

Frequently Asked Questions

How do I find gastric cancer clinical trials I'm eligible for?

Enter your gastric cancer details into ClinTrialFinder — including HER2 status, CLDN18.2 expression, MSI/MMR status, PD-L1 CPS, and prior treatments. The AI matches you with trials based on your specific profile in minutes.

What gastric cancer trials are currently recruiting?

There are 543 recruiting interventional trials for gastric cancer including HER2-targeted ADCs, CLDN18.2-targeted therapies (zolbetuximab, AZD0901, IBI343), perioperative chemoimmunotherapy, MSI-H/dMMR-specific immunotherapy, and novel PD-L1 × VEGF bispecifics.

Are there clinical trials for CLDN18.2-positive gastric cancer?

Yes. Multiple Phase 3 trials test CLDN18.2-targeted therapies including zolbetuximab combinations, AZD0901, IBI343, and JS107 in CLDN18.2-positive gastric/GEJ cancer. Enrollment typically requires confirmed CLDN18.2 expression by IHC.

How does HER2 status affect trial eligibility?

HER2-positive (IHC 3+ or IHC 2+/ISH+) gastric cancer has its own treatment paradigm with trastuzumab-based and HER2 ADC trials (trastuzumab deruxtecan, disitamab vedotin, BL-M07D1). HER2-low (IHC 1+ or IHC 2+/ISH−) is increasingly being tested in dedicated arms. HER2-negative trials usually exclude HER2+ patients to avoid suboptimal treatment.

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