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Participants with pathologically diagnosed locally advanced unresectable or metastatic gastric cancer\u002Fgastroesophageal junction adenocarcinoma (GC\u002FGEJA).\n2. ≥18 years of age at the time of starting the first dose of T-DXd and signing informed consent form (ICF), capable of providing informed consent.\n3. HER2-positive status (IHC 3+ or IHC 2+\u002FISH +).\n4. Received prior anti-cancer treatment regimens according to National Medical Products Administration indication or clinical judgement of physician.\n5. Decision to newly initiate T-DXd before study ICF signing. If the participants have started the first dose of T-DXd no longer than 21 days before enrollment, they could be enrolled if the signed and dated ICF could be obtained.\n\nExclusion Criteria：\n\nParticipants who meet any of the following criteria will be excluded from the study:\n\n1. Pregnancy or breastfeeding.\n2. 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