Trial Comparing Standard of Care Therapy With and Without Sequential Cytoreductive Intervention for Patients With Metastatic Foregut Adenocarcinoma and Undetectable Circulating Tumor-Deoxyribose Nucleic Acid (ctDNA) Levels

This study is testing whether surgically removing or ablating the primary tumor — after it responds well to standard chemotherapy and when a blood marker called ctDNA becomes undetectable — improves survival in patients with metastatic cancers of the digestive tract (stomach, pancreas, bile ducts, gallbladder, and others). **You may be eligible if...** - You have been diagnosed with Stage IV adenocarcinoma of the esophagus, stomach, pancreas, bile ducts, gallbladder, duodenum, or ampulla - Your primary tumor is considered surgically removable or treatable with radiation/ablation - Your ctDNA level (cancer DNA found in blood) has become undetectable after initial chemotherapy - Your cancer has been confirmed by biopsy **You may NOT be eligible if...** - Your ctDNA is still detectable after chemotherapy - Your primary tumor cannot be removed or treated with a local procedure - You do not meet organ function or performance requirements Talk to your doctor to see if this trial is right for you.