Clinical Research Directory

Inclusion Criteria: * Histologically confirmed gastric adenocarcinoma * Clinically diagnosed as locally advanced gastric cancer (cT2-4aNanyM0) * Age 18-75 years, male or female * Eastern Cooperative Oncology Group (ECOG) performance status 0-1 * Adequate organ and hematologic function: * Absolute neutrophil count (ANC) ≥ 1.5 × 10\^9/L * Platelets ≥ 100 × 10\^9/L * Hemoglobin ≥ 90 g/L * Total bilirubin ≤ 1.5 × upper limit of normal (ULN) * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 × ULN * Creatinine ≤ 1.5 × ULN or estimated creatinine clearance ≥ 50 mL/min * Measurable lesion according to RECIST version 1.1 * No prior anti-cancer therapy for the current gastric cancer * Willing and able to provide written informed consent Exclusion Criteria: * Histologically confirmed gastric squamous cell carcinoma, adenosquamous carcinoma, or neuroendocrine carcinoma * Distant metastasis (M1) or unresectable disease * History of other malignancies within the past 5 years (except adequately treated non-melanoma skin cancer or in situ cervical cancer) * Prior treatment with PD-1/PD-L1 inhibitors, iron supplementation, or chemotherapy for gastric cancer * Known hypersensitivity to any study drug components * Active or uncontrolled autoimmune disease * Severe cardiovascular disease (New York Heart Association class III-IV) or myocardial infarction within 6 months * Active infection requiring systemic anti-infective therapy * Pregnancy or breastfeeding women * Inability to comply with study procedures or follow-up