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CompletedNCT04354662Updated Aug 11, 2026

Toripalimab Combined With FLOT Neoadjuvant Chemotherapy in Patients With Resectable Gastric Cancer

A Phase 2 interventional study of Toripalimab and Docetaxel in Gastric Cancer, sponsored by Tianjin Medical University Cancer Institute and Hospital. Completed at 1 site in China. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-08-11.

Sponsored by Tianjin Medical University Cancer Institute and Hospital · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
51
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Gastric cancer is one of the most common malignant tumors of the digestive tract. Gastric cancer patients diagnosed for the first time in China have a higher proportion of advanced stages and a higher postoperative metastasis rate. Studies have shown that patients with good pathological response after preoperative neoadjuvant therapy (such as tumor regression grade, TRG0 or 1) have a better prognosis. The AIO-FLOT4 study found that preoperative perioperative FLOT chemotherapy not only prolonged the progression-free survival (PFS) time and overall survival (OS) time of patients with advanced gastric cancer, but also increased postoperative pathological remission rate. How to further improve the efficacy of the perioperative treatment plan may be beneficial to improve the long-term survival of gastric cancer patients. Several clinical studies have also confirmed that PD-1 antibody significantly prolongs the life of gastric cancer patients who have failed advanced chemotherapy in the back-line treatment. Thus the investigators plan to conduct this clinical trials to evaluate the safety and efficacy of Toripalimab (PD-1 antibody) combined with FLOT regimen in the perioperative period.The secondary end points included pathological remission rate, resection rate, D2 radical resection rate, 5-year disease-free survival (DFS) rate and 5-year OS rate.

Read the detailed description

Gastric cancer is one of the most common malignant tumors of the digestive tract, accounting for the second incidence of malignant tumors, and the third mortality factor related to malignant tumors. In China, most patients with gastric cancer diagnosed for the first time are already in the advanced stage, with stage II and III patients accounting for 63%, and the postoperative recurrence rate is higher. Studies have shown that patients with good pathological response after preoperative neoadjuvant therapy (such as TRG0 or 1) have a better prognosis. In recent years, the AIO-FLOT4 study have found that perioperative chemotherapy with FLOT regimen has prolonged the PFS and OS in patients with advanced gastric cancer. It is preferred to recommend perioperative chemotherapy with FLOT regimen for patients with advanced gastric cancer in the NCCN guidelines or Chinese CSCO guidelines. How to further improve the efficacy of the perioperative treatment plan may be beneficial to improve the long-term survival of gastric cancer patients.

Several clinical studies have also confirmed that PD-1 antibody significantly prolongs the life of gastric cancer patients who have failed advanced chemotherapy in the back-line treatment. In the KEYNOTE-059 study, the effectiveness of chemotherapy combined with PD-1 antibody in gastric cancer patients newly treated reached 62%. It is necessary to explore the efficacy of PD-1 antibody combined with FLOT regimen in the perioperative period. Thus the investigators plan to conduct this clinical trials to evaluate the safety and efficacy of Toripalimab (PD-1 antibody) combined with FLOT regimen in the perioperative period.The secondary end points included pathological remission rate, resection rate, D2 radical resection rate, 5-year DFS rate and 5-year OS rate.

02

Conditions studied

  • Gastric Cancer

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Keywords

  • Gastric Cancer
  • Neoadjuvant Chemotherapy
  • Immunotherapy
  • Toripalimab
  • Pathological Remission
03

In context

Stomach Neoplasms

2,851 studies on the registry are indexed under Stomach Neoplasms; 864 are open to participants now.

This study's enrollment of 51 is below the median of 67 across 2,096 interventional studies indexed under Stomach Neoplasms.

Browse Stomach Neoplasms studies →

Lead sponsor

Tianjin Medical University Cancer Institute and Hospital is the lead sponsor of 484 studies on the registry; 286 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. locally advanced (>T1) and/or nodal positive (N+) histologically proven adenocarcinoma of the gastric or gastroesophageal junction without distant metastases (M0)
  2. no previous surgical resection
  3. no previous cytostatic chemotherapy
  4. Age > 18 years, no more than 75 years (female and male)
  5. Karnofsky Performance Status score of physical condition is 80-100
  6. surgical resectability
  7. Exclusion of peritoneal carcinomatosis (if clinically suspected) via laparoscopy
  8. Leucocytes > 4.000/µl
  9. Platelets > 100.000/µl
  10. Serum creatinin ≤ 1.5x of normal value, or Creatinin-Clearance > 50 ml/min
  11. written informed consent.

Exclusion criteria

Exclusion Criteria:

  1. Distant metastasis or local invasion of adjacent organs;
  2. Recurrent or residual gastric cancer;
  3. Having or having had autoimmune disease;
  4. Previous organ transplantation or HIV patients;
  5. Allergy or contraindications to Toripalimab, 5- Fluorouracil, Leucovorin, Oxaliplatin, and Docetaxel;
  6. Malignant secondary disease;
  7. Severe non-surgical disease or acute infection;
  8. Peripheral polyneuropathy > NCI grad I;
  9. Blood system, liver and kidney function were damaged;
  10. Symptomatic brain metastasis;
  11. Obvious arrhythmia, myocardial ischemia, severe atrioventricular block, cardiac insufficiency and severe gravity valve disease;
  12. Psychotic subjects who are not easy to control;
  13. Pregnant or lactating subjects.
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
51 participants (actual)

Study arms

  • Experimental
    Toripalimab combined with FLOT

    In the perioperative period, patients with resectable gastric cancer is treated with flot regimen combined with Toripalimab to observe whether the 3-year disease-free survival (DFS) rate, pathological remission rate, R0 resection rate, D2 radical resection rate, 5-year DFS rate and 5-year OS rate could be improved.

    Drug: Toripalimab · Drug: Docetaxel · Drug: Fluorouracil · Drug: Leucovorin · Drug: Oxaliplatin

Interventions

  • DrugToripalimab

    240mg d1

    Also known as: JS001

  • DrugDocetaxel

    50mg/m2, d1;

  • DrugFluorouracil

    2600 mg/m², d1

  • DrugLeucovorin

    200 mg/m², d1

  • DrugOxaliplatin

    85 mg/m², d1

06

What researchers measure

Primary outcomes

  1. Pathological complete response rate (pCR)

    Proportion of patients with gastric cancer who received Toripalimab combined with FLOT regimen after 4 cycles of neoadjuvant therapy and postoperative pathological examination TRG 0

    Time frame: Up to 6 months

  2. 3-year Disease-Free Survival Rate

    The primary end point of the study is the effect of perioperative time flot regimen combined with Toripalimab and D2 radical operation on the 3-year disease-free survival time of resectable gastric cancer.

    Time frame: Up to 3 years

Secondary outcomes

  1. Major pathological (complete and nearly complete) response (MPR)

    Proportion of patients with gastric cancer who received Toripalimab combined with FLOT regimen after 4 cycles of neoadjuvant therapy and postoperative pathological examination TRG1a or 1b.

    Time frame: Up to 6 months

  2. Adverse Events

    For any adverse reactions, the researchers refer to the National Cancer Institute (NCI) standard of common toxicity (CTC)

    Time frame: Up to 6 months

  3. 5-year Disease-Free Rate

    The proportion of patients with resectable gastric cancer who have no recurrence or metastasis after 5 years of perioperative treatment

    Time frame: Up to 5 years

  4. 5-year Survival Rate

    Proportion of patients with resectable gastric cancer who survived 5 years after perioperative treatment

    Time frame: Up to 5 years

07

Study locations

1 site
  • Tianjin Medical University Cancer Institute & Hospital
    Tianjin, Tianjin Municipality 300060, China
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 11, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04354662
Lead sponsor
Tianjin Medical University Cancer Institute and Hospital
Responsible party
Sponsor
First posted
Apr 21, 2020
Start date
May 25, 2020
Primary completion
Aug 31, 2022
Completion
Jul 6, 2026
Last update
Aug 11, 2026

Study contacts

Hongli Li, Dr
principal investigator · Tianjin Medical University Cancer Institute and Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2024. You cannot join it, but the record below documents what was studied.

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