Inclusion Criteria:
* Aged 18-75 years old, male or female;
* Previously untreated, surgically resectable adenocarcinoma of the stomach or gastroesophageal junction;
* Clinical stage cT3-4a/N+M0;
* ECOG performance status 0-1;
* Adequate function of major organs assessed within 7 days before treatment:
1. Hematological indicators (without blood transfusion within 14 days):
Hemoglobin (HB) ≥90 g/L; Absolute neutrophil count (ANC) ≥1.5×10⁹/L; Platelet (PLT) ≥80×10⁹/L;
2. Biochemical indicators:
Total bilirubin (TBIL) ≤1.5 × upper limit of normal (ULN); Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 × ULN; Serum creatinine (Cr) ≤1.5 × ULN or creatinine clearance (CCr) ≥60 ml/min;
3. Assessed by Doppler echocardiography: left ventricular ejection fraction (LVEF) ≥ lower limit of normal (50%);
4. Thyroid function: thyroid stimulating hormone (TSH) ≤ ULN;
* Subjects of childbearing potential agree to use effective contraception during the study and for 6 months after the end of study treatment;
* Subjects voluntarily participate in this study and sign written informed consent.
Exclusion Criteria:
* Inclusion Criteria:
* Aged 18-75 years old, male or female;
* Previously untreated, surgically resectable adenocarcinoma of the stomach or gastroesophageal junction;
* Clinical stage cT3-4a/N+M0;
* ECOG performance status 0-1;
* Adequate function of major organs assessed within 7 days before treatment:
1. Hematological indicators (without blood transfusion within 14 days):
Hemoglobin (HB) ≥90 g/L; Absolute neutrophil count (ANC) ≥1.5×10⁹/L; Platelet (PLT) ≥80×10⁹/L;
2. Biochemical indicators:
Total bilirubin (TBIL) ≤1.5 × upper limit of normal (ULN); Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 × ULN; Serum creatinine (Cr) ≤1.5 × ULN or creatinine clearance (CCr) ≥60 ml/min;
3. Assessed by Doppler echocardiography: left ventricular ejection fraction (LVEF) ≥ lower limit of normal (50%);
4. Thyroid function: thyroid stimulating hormone (TSH) ≤ ULN;
* Subjects of childbearing potential agree to use effective contraception during the study and for 6 months after the end of study treatment;
* Subjects voluntarily participate in this study and sign written informed consent.
Exclusion Criteria:
* History of hypersensitivity to any component of QL1706, tegafur-gimeracil-oteracil potassium, oxaliplatin, docetaxel, or any of their excipients;
* History of other malignant tumors within the past 5 years or concurrent other malignant tumors, except cured carcinoma in situ of cervix, non-melanoma skin cancer, and superficial bladder tumors;
* Patients with distant metastasis or unresectable disease;
* Prior receipt of immunotherapy (anti-PD-1, anti-PD-L1, anti-CTLA-4, etc.);
* Received any anti-tumor agents within 4 weeks prior to the first study drug administration;
* Patients with intestinal obstruction (including incomplete intestinal obstruction) or other gastrointestinal diseases that may lead to gastrointestinal hemorrhage, perforation or obstruction;
* Patients with any bleeding event ≥ CTCAE Grade 3, unhealed wounds, ulcers or fractures within 4 weeks before screening;
* Concurrent enrollment in another interventional clinical trial, except observational (non-interventional) clinical trials or follow-up phase of interventional trials;
* Subjects requiring systemic treatment with corticosteroids (\>10 mg prednisone equivalent daily) or other immunosuppressants within 2 weeks before the first study drug administration;
* Received live vaccines within 4 weeks prior to the first study drug administration;
* Underwent major surgery or suffered trauma within 4 weeks before the first study drug administration;
* Active autoimmune disease or history of autoimmune disease, except vitiligo or childhood asthma/allergy that has resolved and requires no intervention in adulthood;
* History of immunodeficiency, including positive HIV test, other acquired or congenital immunodeficiency diseases, or history of organ transplantation and allogeneic bone marrow transplantation;
* Subjects with inadequately controlled cardiovascular clinical symptoms or diseases;
* Severe infection (CTCAE Grade \> 2) occurring within 4 weeks prior to the first study drug administration;
* History of interstitial lung disease (except radiation pneumonia without corticosteroid treatment), non-infectious pneumonia, active pulmonary tuberculosis infection; patients with history of active pulmonary tuberculosis infection within 1 year before enrollment, or patients with history of active pulmonary tuberculosis infection more than 1 year ago without standardized treatment;
* Pregnant or breastfeeding women;
* Other concomitant diseases that, in the investigator's opinion, may seriously endanger the subject's safety or prevent the subject from completing the study.
