Blood test guides aggressive attack on spreading stomach and pancreatic cancers

This study is for people with advanced cancer that started in the upper digestive tract (like the stomach, pancreas, or bile ducts) and has spread to only a few other places. After three months of chemotherapy, if a special blood test finds no cancer DNA, patients are randomly assigned to either continue standard chemotherapy alone or to also receive targeted treatments like surgery or radiation to remove the remaining tumors. The main goal is to see if adding these local treatments helps keep the cancer from growing back longer than chemotherapy alone.