Neoadjuvant Propranolol Plus SOX and Toripalimab for Locally Advanced Gastric/GEJ Adenocarcinoma

Exclusion criteria

• . Distant metastatic disease confirmed by imaging or diagnostic laparoscopy, including but not limited to peritoneal, hepatic, or bone metastases, or positive peritoneal cytology.
• . Previous systemic anticancer treatment for the current malignancy, including chemotherapy, immunotherapy, or targeted therapy, or previous radiotherapy. Diagnostic endoscopy and biopsy are permitted.
• . Grade 2 or higher peripheral neuropathy at baseline.
• . A second primary malignancy requiring systemic treatment within the previous 3 years, except for adequately treated basal cell or squamous cell carcinoma of the skin, carcinoma in situ of the cervix, low-risk thyroid cancer, or other malignancies considered cured.
• . Inability to tolerate curative-intent surgery or study treatment, as determined by the investigator.
• . Active autoimmune disease, or a clinically significant history of autoimmune disease requiring systemic immunosuppressive treatment within the previous 2 years. Participants with type 1 diabetes mellitus, stable thyroid disease requiring replacement therapy, vitiligo, or grade 2 or lower psoriasis not requiring systemic treatment may be eligible.
• . Use of systemic corticosteroids at a prednisone-equivalent dose of at least 10 mg/day, or other systemic immunosuppressive agents, within 14 days before the planned initiation of immunotherapy. Physiologic replacement therapy, inhaled or topical corticosteroids, and short-term prophylactic treatment related to surgery are permitted.
• . Active infection, including but not limited to active tuberculosis, uncontrolled hepatitis B virus or hepatitis C virus infection, human immunodeficiency virus infection, or another serious infection requiring intravenous antibiotic treatment.