A Single-arm, Multicenter Exploratory Clinical Trial of Anlotinib Combined With TQB2450 and the SOX Regimen as First-line Treatment for Advanced Gastric Cancer With Low PD-L1 Expression

This study is testing a combination of three anti-cancer drugs — anlotinib (a targeted therapy that blocks tumor blood vessel growth), TQB2450 (an immunotherapy), and SOX chemotherapy (oxaliplatin plus tegafur/gimeracil/oteracil) — as a first-line treatment for people with advanced gastric or gastroesophageal junction cancer that has low levels of a protein called PD-L1. **You may be eligible if...** - You are between 18 and 75 years old - You have confirmed advanced or metastatic stomach or gastroesophageal junction cancer that is HER2-negative - You have not previously received treatment for this metastatic disease (though prior surgery/chemo/radiation for earlier-stage disease is allowed if completed more than 6 months ago) - Your general health is good and your organ function is within acceptable ranges - You have at least one measurable tumor **You may NOT be eligible if...** - You have already received first-line chemotherapy for metastatic disease - Your organ function (liver, kidneys, blood counts) is significantly impaired - You have active uncontrolled infections, autoimmune conditions, or significant heart problems - Your performance status is too low for chemotherapy Talk to your doctor to see if this trial is right for you.