Conversion Therapy of Sintilimab in Combination With Apatinib and Chemotherapy in Stage IV Gastric Cancer

Exclusion Criteria

• •prior use of any checkpoint inhibitor treatment, including PD-1, programmed cell death ligand-1(PDL-1), CTLA4 etc;
• •Her-2 positive with willing to use herceptin treatment;
• •prior active autoimmune disease or history of autoimmune disease;
• •clinically significant cardiovascular and cerebrovascular diseases, including but not limited to severe acute myocardial infarction within 6 months before enrollment, unstable or severe angina, or coronary artery bypass surgery, Congestive heart failure (New York heart association (NYHA) class \> 2), ventricular arrhythmia which need medical intervention, left ventricular ejection fraction(LVEF) \< 50%;
• •not controlled hypertension;
• •prior systemic treatment to metastatic disease；
• •previous digestive tract bleeding history within 3 months or evident gastrointestinal bleeding tendency;
• •history of immunodeficiency including seropositivity for human immunodeficiency virus (HIV), or other acquired or congenital immune-deficient disease, or active hepatitis ;
• •patients who may receive vaccination during study period;
• •mental disorders history, or psychotropic drug abuse history;
• •unable to orally administration;