XELOX Combined With Anlotinib and Penpulimab vs XELOX as Adjuvant Therapy in ctDNA Positive Gastric and Esophagogastric Junction Adenocarcinoma

This study is testing whether adding two targeted drugs — anlotinib and penpulimab — to standard chemotherapy (XELOX) after surgery can help prevent stomach or stomach-esophagus junction cancer from coming back in patients whose cancer DNA (ctDNA) is still detectable in the blood after surgery. The presence of ctDNA after surgery suggests a higher risk of relapse. This is an adjuvant (post-surgical) therapy trial. **You may be eligible if...** - You are between 18 and 75 years old with confirmed gastric or gastroesophageal junction cancer - You had radical surgical removal (D2 resection) of your cancer - Your cancer is stage III (based on the 8th AJCC system) - Your ctDNA (circulating tumor DNA in the blood) is detectable after surgery - You are in good health with adequate blood counts, liver, and kidney function **You may NOT be eligible if...** - You have distant spread (metastatic disease) - You have signs of another active cancer - You have serious heart, liver, or kidney problems - You are pregnant or planning pregnancy Talk to your doctor to see if this trial is right for you.