Disitamab Vedotin, Fruquintinib and Tislelizumab in Second-line Treatment for HER2-positive MGC

Inclusion Criteria:

1. older than18 years of age, gender not limited;
2. the histologic diagnosis of the stomach or gastroesophageal junction adenocarcinoma;
3. immunohistochemical HER2 2 + 3 + or HER2, FISH is positive;
4. at least have a measurable lesions (10 mm or higher spiral CT scan, RECIST 1.1standard);
5. First-line treatment failure of fluorouracil and the platinum, or to accept containingfluorouracil and platinum adjuvant chemotherapy in patients with recurrence after 6months;
6. ECOG 0-2, expected survival for 3 months or more;
7. the subjects treated with other damage has been restored, accepting radiotherapyshould be ended more than 3 weeks;
8. major organs function is normal, the group within 1 week before the lab test resultsmeet the following criteria: (1) The standard of blood routine examination shall meet:
9. HB≥80g/L;
10. ANC ≥1.5×109/L;
11. PLT ≥75×109/L (2) Biochemical examination shall meet the following standards: a. Total bilirubin BIL < 1.25 * upper limit of normal (ULN) B. the ALT and ASTacuities were 2.5 * ULN. C. serum creatinine (Cr) of 1.5 or less * ULN, endogenouscreatinine clearance > 50 ml/min (Cockcroft - Gault formula)
12. participants voluntarily participate in this study, and signed by himself or agentinformed consent; Patient compliance is good, can cooperate with the relevantexamination, treatment and follow-up.

Exclusion Criteria:

1. history of other malignant tumors within 3 years, have cured except cervical carcinomain situ or skin basal cell carcinoma;
2. with brain or meningeal metastasis;
3. associated with gastrointestinal obstruction, gastrointestinal bleeding (defecateoccult blood + + + and above) or perforation;
4. with active, or have a history and possible recurrence of autoimmune disease of thesubjects (such as: Systemic lupus erythematosus, rheumatoid arthritis, inflammatorybowel disease, autoimmune thyroid disease, multiple sclerosis, vasculitis,glomerulonephritis, etc.), or those at high risk (such as those who have received anorgan transplant requiring immunosuppressive therapy), However, patients withvitiligo, psoriasis, alopecia, or Grave's disease who did not require systemictreatment within the last 2 years, or patients with hypothyroidism who only neededthyroid hormone replacement therapy, and patients with type I diabetes who only neededinsulin replacement therapy could be enrolled;
5. now with interstitial lung disease or pneumonia, pulmonary fibrosis, acute lungdiseases, radiation pneumonia;
6. within 4 weeks before delivery for the first time to participate in any other drugclinical research (the use of test drugs shall prevail), unless the participantobservation (non intrusive) clinical research;
7. within 4 weeks before the first dose of study treatment used immunosuppressive drugs,Does not include nasal, inhalation or other routes of topical corticosteroids orphysiological doses of systemic corticosteroids (i.e., not exceeding 10 mg/ day ofprednisone or equivalent doses of other corticosteroids), or short-term (not exceeding 7 days) use of corticosteroids for the prevention or treatment of non-autoimmuneallergic diseases;
8. within 4 weeks before the first dose of study treatment or accept the live attenuatedplan during the study period. Note: Inactivated virus vaccines for injectable seasonalinfluenza are permitted for up to 4 weeks prior to initial administration; But liveattenuated influenza vaccines are not allowed;
9. within 4 weeks before the first dose of study treatment received major surgery, openchest or craniotomy laparotomy or expected during the research and treatment need toaccept of this study major surgery.
10. infected with human immunodeficiency virus (HIV) disease (i.e., an HIV positive), orwith other acquired, congenital immunodeficiency disease, or has a history of historyof organ transplantation, or stem cell transplantation;
11. chronic active hepatitis b or active active hepatitis c, hepatitis b virus carriers,stable after drug treatment of hepatitis b (DNA drop degree is not higher than 200iu/mL or copy number Copies <1000copies/mL) and cured hepatitis C patients (HCV RNAtest negative) could be included;
12. with known active tuberculosis;
13. first before 4 weeks with severe infections, or 2 weeks before appear active infectionneed oral or intravenous antibiotic therapy patients;
14. symptomatic congestive heart failure (New York heart association grade II - IV) orsymptomatic or poorly controlled arrhythmia.
15. even give specification treatment still uncontrolled arterial blood pressure (systolicblood pressure or greater acuity 160 MMHG or diastolic blood pressure, 100 MMHG).
16. within 6 months before the selected treatment occurred any arterial thromboembolicevents, including myocardial infarction, unstable angina, cerebrovascular accident, ortransient ischemic attack.
17. within 3 months before the group with deep vein thrombosis, pulmonary embolism, or anyother serious history of thromboembolism (implantable venous infusion port source sexor catheter thrombosis, or superficial venous thrombosis were not regarded as a "severe" thromboembolism).
18. always have a clear history of neurological or psychiatric disorders, such as memory,epilepsy, dementia, compliance, or the peripheral nervous system disorder;
19. alcohol dependence or nearly 1 year has a history of drug or drug abuse;
20. pregnancy or lactation women; Those who are fertile but do not take adequatecontraceptive measures;
21. may lead to the following results of other acute or chronic diseases, mental illnessor abnormal laboratory values: participated in or study drug dosage associated with anincreased risk, or interfere with the interpretation of results, and according to theresearcher's judgment will be patient as does not conform to participate in thisstudy.