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Helicobacter pylori and Gastric Cancer Risk: Causes, Transmission, Eradication, and Symptoms

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

This is a well-structured and informative piece about Helicobacter pylori (H. pylori) and its link to gastric cancer. Here’s a breakdown of its strengths and some potential areas for minor refinement:

Strengths:

Clear and logical Flow: The text moves seamlessly from the initial statement about Europe to transmission routes, eradication, symptoms, and finally tumor management. This makes it easy for the reader to follow the progression of details. Expert Quotations: The inclusion of Mรณnica Manzano‘s quotes adds credibility and provides specific, actionable advice on eradication and testing.
Complete Coverage: the article touches upon key aspects of H. pylori, including its prevalence, how it spreads, how to get rid of it, what symptoms to look out for, and what happens if it leads to cancer.
 Practical Advice: The “Eradication” section offers practical, everyday tips for prevention and treatment, which are highly valuable for the reader.
Emphasis on Early Detection: The “Symptoms of infection” section effectively highlights the importance of recognizing subtle signs and seeking medical attention promptly.
 Good Use of Terminology: The article uses appropriate medical terms (gastric mucosa, precancerous lesions, dysphagia, endoscopy, biopsies, tomography, ecoendoscopy, PET) without being overly technical, making it accessible to a general audience.
Contextualization: The initial statement about Europe provides a useful geographical context and hints at factors influencing H.pylori prevalence.

Potential Areas for Minor Refinement (More for stylistic preference than necessity):

Transition from Europe to Transmission: While the initial statement about Europe is interesting, the transition to “Transmission route” could be slightly smoother.Perhaps a sentence like, “Understanding the transmission routes is crucial for addressing the global burden of H. pylori, including in regions like Europe,” could bridge the gap.
Repetition of “gastric cancer”: While the topic is gastric cancer, the phrase appears frequently. Varying sentence structure or using synonyms like “stomach cancer” or “cancer of the stomach” in a few instances could enhance readability.
 “The aforementioned study”: While it’s clear what “the aforementioned study” refers to within the context of the original source,if this were a standalone piece,it might be beneficial to briefly re-state the study’s focus or origin for absolute clarity. However, given the provided text, it’s understandable.
* “Involuntary weight loss”: While accurate, “unexplained weight loss” might be a more common phrasing for a symptom.

Overall Impression:

This is a vrey good piece of writing that effectively communicates important information about H. pylori and its connection to gastric cancer. It’s informative, practical, and well-organized. The inclusion of expert advice and clear symptom descriptions makes it a valuable resource for anyone seeking to understand this health issue.

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Health

Antibody-Drug Conjugate SHR-A1904 for CLDN18.2 Targeting in Advanced Gastric Cancer

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

New clinical Trial Data Highlights Potential of Novel Cancer Therapy

Changsha, China – A multi-center Phase I clinical trial has yielded promising results for a novel therapeutic approach in oncology, wiht researchers from Xiangya Hospital Central South University leading the charge. The study, which involved a comprehensive network of institutions across China, aimed to evaluate the safety and efficacy of a new treatment regimen.

The trial’s findings, detailed in the full article, represent a critically important step forward in the ongoing effort to develop more effective cancer treatments. The research team, comprising experts from leading medical institutions and pharmaceutical companies, meticulously analyzed data to assess the treatment’s impact.

Key contributors to this research include Ping-Sheng Xu from Xiangya Hospital Central South University,ai-Li Suo from The first Affiliated Hospital of Xi’an Jiaotong University,Rui-Nuo Jia from The First Affiliated Hospital of Henan University of Science & Technology,Yong-Qiang Li from the Cancer Hospital Affiliated to Guangxi medical University,and Xiao-Dong Peng from The First Affiliated Hospital of Nanchang University. Pharmaceutical expertise was provided by Si-Chen Wang, You have yu, and Jie Xie from Jiangsu Hengrui Pharmaceuticals Co., Ltd. The study also benefited from the contributions of Miao-Zhen Qiu and Rui-Hua Xu from Sun Yat-sen University Cancer Center.

Rui-Hua Xu is credited with full access to all study data and bears responsibility for the integrity of the data and the accuracy of the analysis. The conceptualization and design of the study were led by R.-H.X. Data acquisition, analysis, and interpretation involved all authors. The manuscript was primarily drafted by D.-Y.R. and H.-X.W.,with critical revisions provided by a broad spectrum of the research team,including R.-H.X., M.-Z.Q.,S.-X.L., W.-W.H.,X.-J.L., Z.-X.N., Q.D., H.-L. Li, Z.-Y.P., H.-X.L., Y.-Q.Z., X.-Y.L., X.-Y.X., S.-R.C., Y.-G.D., J.Z., Z.L.,H.-T.L., X.W., Y.Z., L.L., H.-L. Liu, P.-S.X., A.-L.S., R.-N.J., Y.-Q.L., X.-D.P., S.-C.W., A.-A.Y., and J.X. Statistical analysis was performed by A.-A.Y. Administrative, technical, and material support was provided by R.-H.X., M.-Z.Q., D.-Y.R., H.-X.W., S.-C.W.,A.-A.Y., and J.X. Supervision of the study was overseen by R.-H.X. and M.-Z.Q.

This research underscores the collaborative nature of modern medical advancements and highlights the ongoing pursuit of innovative therapies to combat cancer.

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Business

Content Writing Tips: Improve Your Skills & Productivity

by Priya Shah โ€“ Business Editor
written by Priya Shah โ€“ Business Editor

The FDA has granted orphan drug designation to ADRX-0405, a STEAP1-directed antibody-drug conjugate (ADC), for the treatment of patients with gastric cancer.1

The agent is under investigation in the phase 1a portion of an ongoing phase 1a/b trial (NCT06710379) in patients with certain advanced solid tumors, including metastatic castration-resistant prostate cancer (mCRPC), gastric cancer, and nonโ€“small cell lung cancer (NSCLC).

โ€œReceiving orphan drug designation from FDA is a notable milestone for Adcentrx and reinforces the potential for ADRX-0405 to improve the lives of patients with gastric cancer,โ€ Hui Li, PhD, founder and chief executive officer of Adcentrx, stated in a news release. โ€œWe are encouraged by the progress of our phase 1a trial and look forward to further evaluating the safety, tolerability and anti-tumor activity of ADRX-0405 in gastric and other cancers.โ€

ADRX-0405 is a next-generation ADC targeting STEAP1, a cell surface protein that is upregulated primarily in prostate cancer and several other cancers including gastric cancer. The ADC houses a humanized IgG1 antibody combined with a novel topoisomerase inhibitor linker payload to improve drug delivery. Specifically, ADRX-0405 binds STEAP1, which triggers H2AX phosphorylation and PARP cleavage, leading to nanomolar and target-dependent cytotoxicity in tumor cells.2

With a drug-antibody ratio of 8, ADRX-0405 has proved to be a highly stable ADC, showcasing favorable pharmacokinetics, safety, and efficacy in preclinical study.1,2 In a patient-derived xenograft mouse model of prostate cancer with high and low STEAP1 expression, ADRX-0405 led to an overall response rate (ORR) of 83%.2

The ongoing phase 1a/b trial was designed to evaluate the safety, tolerability, pharmacokinetics, and optimal dose of ADRX-0405 in patients with histologically confirmed mCRPC, gastric cancer, and NSCLC.3

To be eligible for enrollment, patients needed to have measurable disease according to RECIST 1.1 criteria or evaluable disease per Prostate Cancer Working Group 3 criteria for those with prostate cancer; an ECOG performance status of 0 or 1 in phase 1a or 0 to 2 in phase 1b; and adequate hematologic, liver, and renal function.

In phase 1b, patients must have histologically confirmed castration-resistant prostate adenocarcinoma with a serum testosterone level below 50 ng/dL that is intolerant or resistant to standard therapy.

Exclusion criteria include active and uncontrolled central nervous system metastases; significant cardiovascular disease; history of another malignancy within 3 years; exposure to any anticancer or investigational therapy within 5 elimination half-lives or 14 days, or 4 weeks for any therapeutic radiopharmaceutical for prostate cancer; history of interstitial lung disease or pneumonitis or a suspicion thereof, and exposure to systemic antimicrobial treatment for active infection.

In the phase 1a dose escalation portion of the trial eligible patients will receive escalating doses of ADRX-0405 to determine the maximum tolerated dose and recommended dose for expansion. In dose expansion only patients with previously treated mCRPC will receive ADRX-0405.

The primary end point is the incidence of adverse effects. Secondary end points include pharmacokinetic measures, as well as ORR, duration of response, disease control rate, progression-free survival (PFS), radiographic PFS, and overall survival.

In January 2025, the developer announced the first patient had been dosed in the trial and the first data readout was planned for the fourth quarter of 2025.4

References

  1. U.S. FDA grants orphan drug designation to Adcentrx Therapeuticsโ€™ ADRXโ€‘0405 STEAP1 ADC for gastric cancer. News release. Adcentrx Therapeutics. July 8, 2025. Accessed July 11, 2025. https://www.adcentrx.com/adcentrx-therapeutics-adrx-0405-steap-1-adc-granted-orphan-drug-designation-for-the-treatment-of-gastric-cancer/
  2. Shahmoradgoli M, Hau AM, Betancourt O, et al. Preclinical characterization of a novel STEAP1 antibody-drug conjugate ADRX-0405 for the treatment of mCRPC. Cancer Res. 2025;85(suppl 8):1159. doi:10.1158/1538-7445.AM2025-1159
  3. A study of ADRX-0405 in subjects with select advanced solid tumors. ClinicalTrials.gov. Updated April 9, 2025. Accessed July 11, 2025. https://clinicaltrials.gov/study/NCT06710379
  4. Adcentrx Therapeutics announces first patient dosed in the phase 1a/b study of ADRX-0405, a potential first-in-class ADC targeting STEAP1 for the treatment of advanced solid tumors. News release. Adcentrx Therapeutics. January 6, 2025. Accessed July 11, 2025. https://www.adcentrx.com/adcentrx-therapeutics-doses-first-patient-in-phase-1a-with-adrx-0405-steap1-adc/
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Health

TIGIT/PD-1 Blockade: New Hope for Gastric Cancer Treatment?

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

STAR-221 Trial: Domvanalimab Plus Zimberelimab Shows Promise in Gastric Cancer Treatment

Table of Contents



The STAR-221 trial (NCT05568095), evaluating the combination of domvanalimab plus zimberelimab and chemotherapy, could redefine first-line treatment strategies for gastric cancers, especially in patients with PD-L1-positive tumors.This phase 3 study is the first to investigate an Fc-silent, anti-TIGIT agent in solid tumors, potentially clarifying the therapeutic role of this novel combination.

Understanding the STAR-221 Trial Design

STAR-221 is a phase 3 clinical trial assessing the efficacy and safety of domvanalimab,a TIGIT monoclonal antibody,combined with zimberelimab,a PD-1 inhibitor,and FOLFOX chemotherapy.The trial aims to determine if this combination improves outcomes for patients with gastric cancers compared to the standard chemotherapy plus nivolumab regimen.

Did You Know? TIGIT (T-cell immunoreceptor with Ig and ITIM domains) is an inhibitory receptor found on immune cells, and blocking it can enhance anti-tumor immune responses.

TIGIT Inhibitors: A Novel Approach to Cancer Immunotherapy

TIGIT inhibitors represent a promising class of cancer immunotherapeutic agents. These inhibitors target the TIGIT receptor on immune cells, preventing it from suppressing the immune response against cancer cells. by blocking TIGIT, these agents aim to enhance the activity of immune cells, such as T cells and natural killer cells, to better recognise and destroy cancer cells. This approach is ofen combined with other immunotherapies, such as PD-1 or PD-L1 inhibitors, to achieve a synergistic effect.

The rationale behind targeting TIGIT stems from its role in suppressing immune responses within the tumor microenvironment. TIGIT is often upregulated on exhausted T cells and regulatory T cells (Tregs),contributing to immune evasion by cancer cells. By blocking TIGIT, researchers hope to reinvigorate these immune cells and promote a more robust anti-tumor response.

Fc-Silent vs. Fc-Activated TIGIT Antibodies

TIGIT antibodies can be classified into two main types based on their fc region: Fc-silent and Fc-activated. Fc-silent antibodies are engineered to lack Fc receptor engagement, which means they do not deplete TIGIT-expressing immune cells. Rather, they primarily enhance the expansion of effector cells. In contrast, Fc-activated antibodies retain Fc receptor binding capabilities, leading to antibody-dependent cellular cytotoxicity or complement-dependent cytotoxicity, which can deplete TIGIT-expressing immune cells, including Tregs.

The choice between Fc-silent and Fc-activated TIGIT antibodies depends on the desired mechanism of action and potential toxicity profile. Fc-maintained antibodies may deplete Tregs,which could be beneficial for antitumor response but may also increase autoimmune toxicity. fc-silent antibodies, like domvanalimab, are designed to avoid Treg depletion, potentially leading to a more manageable safety profile.

Phase 2 Data Supporting STAR-221

The development of the domvanalimab/zimberelimab combination is supported by data from the EDGE-Gastric trial, a first-line gastric cancer study. Initial results presented at the 2024 ASCO Annual Meeting showed an objective response rate (ORR) of 59% in the entire population, with a median progression-free survival (PFS) of 12.9 months. While the small sample size is a limitation, these findings suggest an increased ORR and longer median PFS compared to previous pivotal trials like CheckMate 649 and KEYNOTE-859.

Subgroup analysis also indicated that the combination works better in patients with high PD-L1 expression, such as a combined positive score (CPS) of 5% or higher. This aligns with expectations, as TIGIT is often co-expressed with other checkpoints like PD-1 on T effector cells. The safety profile also appears manageable, with no increased autoimmune reactions due to the lack of Treg depletion.

PD-L1 Status and Treatment Outcomes

PD-L1 expression levels play a crucial role in determining the effectiveness of certain cancer treatments. In the context of the STAR-221 trial, PD-L1 status is a key stratification factor. Subgroup analyses are planned to assess the treatment’s effectiveness based on PD-L1 expression levels, with a focus on patients with a CPS of 5% or higher. This is particularly relevant because TIGIT is often co-expressed with other checkpoints like PD-1 on T effector cells,suggesting that patients with high PD-L1 expression may derive greater benefit from the domvanalimab/zimberelimab combination.

Pro Tip: Monitoring PD-L1 expression levels can definitely help clinicians tailor treatment strategies and identify patients who are most likely to respond to specific therapies.

Implications of Positive STAR-221 Results

If the domvanalimab/zimberelimab/chemotherapy combination demonstrates an overall survival (OS) benefit compared to chemotherapy plus nivolumab, it could become a new standard of care, particularly in PD-L1-high populations. Even if the benefit is limited to the PD-L1-high population, it would still represent a significant advancement for these patients. Moreover, if the combination shows an OS benefit irrespective of PD-L1 status, it could be attractive for patients with low PD-L1 status who typically achieve limited benefit with chemotherapy plus a PD-[L]1 inhibitor.

Positive results from STAR-221 could also lead to the inquiry of this agent in other types of tumors where previous anti-TIGIT therapies have failed to show a survival benefit. This could potentially expand the use of domvanalimab/zimberelimab to a broader range of cancer patients.

Current landscape of Gastric Cancer Treatment

Currently, chemotherapy plus nivolumab is a standard treatment for patients with a PD-L1 CPS of 1 or higher. However,this combination has not shown benefit in patients with a CPS less than 1. The STAR-221 trial was initiated before the FDA’s Oncologic Drugs Advisory Committee meeting, which restricted frontline PD-1 inhibitors to patients with HER2-negative, microsatellite-stable gastric/GEJ adenocarcinoma with a PD-L1 CPS greater than 1. Thus, the trial population is expected to be representative of the general gastric cancer population regarding CPS frequency.

The main objective of the STAR-221 study is to assess the treatment effect, especially in patients with a CPS or TAP score of 5% or higher.CPS levels are being monitored during the trial, and the results will be reported after the analysis.

STAR-221: Key Comparison

Treatment Arm Agents Patient Population Primary Endpoint
Experimental Domvanalimab + Zimberelimab + Chemotherapy (FOLFOX/CAPOX) Gastric Cancer Patients Overall Survival (OS)
control Chemotherapy + Nivolumab Gastric Cancer Patients Overall Survival (OS)

What are your thoughts on the potential of Fc-silent antibodies in cancer treatment? How might the results of STAR-221 influence future clinical trials?

Evergreen insights: Background, context, Past Trends

gastric cancer remains a significant global health challenge, ranking as the fifth most common cancer worldwide and the fourth leading cause of cancer-related deaths. In 2020, there were over 1 million new cases and an estimated 769,000 deaths globally, highlighting the urgent need for more effective treatment strategies. The incidence rates vary significantly across different regions, with higher rates observed in Eastern Asia, particularly in countries like China, Japan, and South Korea. These variations are frequently enough attributed to dietary habits, genetic factors, and the prevalence of Helicobacter pylori infection, a major risk factor for gastric cancer.

The treatment landscape for gastric cancer has evolved considerably over the past few decades.Surgery remains the primary curative option for early-stage disease, but many patients are diagnosed at advanced stages when surgery is no longer feasible. In these cases, systemic therapies, including chemotherapy, targeted agents, and immunotherapy, play a crucial role in improving survival outcomes. The introduction of combination chemotherapy regimens,such as FOLFOX and CAPOX,has led to significant improvements in response rates and progression-free survival. However, the overall survival benefits have been modest, underscoring the need for novel therapeutic approaches.

Immunotherapy has emerged as a promising strategy for treating gastric cancer, particularly with the advent of immune checkpoint inhibitors.Agents targeting PD-1 and PD-L1 have demonstrated clinical activity in a subset of patients, leading to their approval as first-line and subsequent-line treatments. Though,not all patients respond to these therapies,and predictive biomarkers,such as PD-L1 expression,are used to identify those most likely to benefit. the development of TIGIT inhibitors, such as domvanalimab, represents the next wave of immunotherapeutic innovation, aiming to overcome resistance mechanisms and enhance anti-tumor immune responses. The STAR-221 trial is a pivotal study that could potentially reshape the treatment paradigm for gastric cancer,offering new hope for patients with this challenging disease.

Frequently Asked Questions About Domvanalimab and Gastric Cancer Treatment

What are the common symptoms of gastric cancer?

Common symptoms of gastric cancer include persistent indigestion, stomach pain, nausea, vomiting, loss of appetite, and unexplained weight loss. However, early-stage gastric cancer may not cause any noticeable symptoms.

How is gastric cancer typically diagnosed?

Gastric cancer is typically diagnosed through a combination of physical examination, medical history review, and diagnostic tests such as endoscopy, biopsy, and imaging studies (e.g., CT scan, PET scan).

What are the risk factors for developing gastric cancer?

Risk factors for gastric cancer include Helicobacter pylori infection, chronic gastritis, smoking, excessive alcohol consumption, a diet high in salt and processed foods, and a family history of gastric cancer.

What are the different stages of gastric cancer?

Gastric cancer is staged using the TNM (Tumor, Node, Metastasis) staging system, which classifies the extent of the tumor, the involvement of regional lymph nodes, and the presence of distant metastasis. The stages range from stage 0 (vrey early-stage cancer) to stage IV (advanced-stage cancer).

What are the treatment options for advanced gastric cancer?

Treatment options for advanced gastric cancer may include chemotherapy,targeted therapy,immunotherapy,radiation therapy,and palliative care. The choice of treatment depends on the stage of the cancer, the patient’s overall health, and other factors.

have you or a loved one been affected by gastric cancer? Share your experiences and thoughts on these emerging therapies in the comments below.

Disclaimer: This article provides information about a clinical trial and potential treatment options for gastric cancer. It is not intended to provide medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment recommendations.

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