Study on New Immunotherapy with Anti-Angiogenesis and Chemotherapy for Advanced Gastroesophageal Cancer

Inclusion Criteria

• Must be 18 years or older and able to provide written consent.
• Must have a performance status score of 0 or 1, indicating full activity or some restriction in strenuous activities.
• Must provide a tumor tissue sample from a biopsy, either done before joining the study or before starting treatment.
• Must be willing to provide tissue and blood samples for research purposes.
• Must have a type of stomach or gastroesophageal cancer that is metastatic, recurrent, or cannot be surgically removed.
• Must be eligible for treatment with pembrolizumab, ramucirumab, and paclitaxel (or nab-paclitaxel).
• Must have adequate organ function as shown by specific blood tests.
• Women of childbearing potential must have a negative pregnancy test and agree to use effective contraception during the study and for 120 days after treatment ends.
• Must be willing to return to the study site for follow-up visits.

Exclusion Criteria

• History of lung disease or conditions that required steroid treatment.
• Heart problems, such as abnormal heart rhythms or recent heart attacks.
• Uncontrolled high blood pressure.
• Recent severe gastrointestinal bleeding.
• Liver disease or conditions causing fluid buildup in the abdomen.
• Recent coughing up of blood or evidence of major blood vessel involvement by cancer.
• Recent serious wounds or surgeries.
• Active autoimmune diseases requiring treatment in the past 6 months.
• Participation in another clinical trial within 4 weeks of starting this study.
• Known HIV or active hepatitis B or C infections.
• Severe allergic reactions to similar medications.
• Active central nervous system metastases unless stable and not requiring steroids.
• Uncontrolled illnesses or infections.
• Pregnant or breastfeeding women.
• Recent live vaccinations.
• Previous severe side effects from similar treatments.
• Previous organ transplants.