Phase II RAINSPOT: Zolbetuximab-Paclitaxel-Ramucirumab for CLDN18.2 Positive Gastro-esophageal Cancer

This study (called RAINSPOT) is testing a three-drug combination — zolbetuximab, paclitaxel, and ramucirumab — for people with stomach or esophageal cancer (gastroesophageal adenocarcinoma) that has spread and come back after one prior treatment. Zolbetuximab is a targeted antibody that works on cancers with a specific protein called CLDN18.2. This is a phase 2 trial. **You may be eligible if...** - You are 18 or older - You have confirmed metastatic stomach or gastroesophageal junction cancer (adenocarcinoma) - Your cancer tests positive for the CLDN18.2 protein (at least 75% of tumor cells show moderate to strong expression) - You have already received one prior standard treatment (chemotherapy with or without immunotherapy) - You are in good general health (performance status 0–1) - You are willing to use effective birth control **You may NOT be eligible if...** - You have squamous cell cancer of the esophagus (this is a different cancer type) - You have contraindications to anti-VEGF drugs (like recent stroke, bleeding, or tumor perforation) - You have another active cancer - You have previously received zolbetuximab or another CLDN18.2-targeted therapy - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.