{"entity":{"id":"cldn18-antibody-then-adc","kind":"pairing","name":"CLDN18.2 antibody first line → CLDN18.2 ADC or CAR-T on progression","aka":[],"tldr":"Hit Claudin 18.2 twice: first with a plain antibody plus chemotherapy, then with an ADC or engineered cells when the cancer comes back.","summary":"Zolbetuximab + chemotherapy is approved first line; CLARITY-Gastric 01 showed an OS benefit for the CLDN18.2 ADC sonesitatug vedotin in later lines (July 2026); satri-cel CAR-T is approved in China. Whether prior zolbetuximab reduces ADC benefit (antigen persistence, ADCC-selected clones) is the key unknown.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03504397: SPOTLIGHT & GLOW","url":"https://clinicaltrials.gov/study/NCT03504397"},{"label":"ClinicalTrials.gov NCT06346392: CLARITY-Gastric 01","url":"https://clinicaltrials.gov/study/NCT06346392"}],"tags":[],"related":[],"cancers":["gastric"],"sections":[],"technologies":[],"targets":["cldn18-2"],"drugs":["zolbetuximab","cmg901","satricabtagene-autoleucel"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["spotlight-glow","clarity-gastric01"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"zolbetuximab","b":"cmg901","rationale":"CLDN18.2 is a lineage antigen that tends to persist; the three modalities kill by different mechanisms (ADCC/CDC, payload, T cells).","evidence":"Phase 3 for each agent individually; sequencing data pending.","pairingType":"sequence"},"route":"/pairings/cldn18-antibody-then-adc/","neighbours":{"cancer":[{"id":"gastric-cldn18-2-positive","kind":"cancer","name":"Claudin 18.2-positive gastric cancer","route":"/cancers/gastric-cldn18-2-positive/"},{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"}],"target":[{"id":"cldn18-2","kind":"target","name":"Claudin 18.2","route":"/targets/cldn18-2/"}],"drug":[{"id":"satricabtagene-autoleucel","kind":"drug","name":"Satricabtagene autoleucel","route":"/drugs/satricabtagene-autoleucel/"},{"id":"cmg901","kind":"drug","name":"Sonesitatug vedotin","route":"/drugs/cmg901/"},{"id":"zolbetuximab","kind":"drug","name":"Zolbetuximab","route":"/drugs/zolbetuximab/"}],"trial":[{"id":"clarity-gastric01","kind":"trial","name":"CLARITY-Gastric 01","route":"/trials/clarity-gastric01/"},{"id":"spotlight-glow","kind":"trial","name":"SPOTLIGHT & GLOW","route":"/trials/spotlight-glow/"}]}}