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Adding the claudin 18.2 antibody zolbetuximab to CAPOX chemotherapy lengthened survival in claudin 18.2-positive advanced gastric cancer, confirming the SPOTLIGHT result with a different chemotherapy backbone.
Phase 3 placebo-controlled trial of 507 patients with untreated claudin 18.2-positive (75 percent or more of tumour cells), HER2-negative locally advanced or metastatic gastric or junctional adenocarcinoma randomised to zolbetuximab or placebo with capecitabine and oxaliplatin.
Median progression-free survival was 8.21 versus 6.80 months (hazard ratio 0.687) and median overall survival 14.39 versus 12.16 months (hazard ratio 0.771); nausea and vomiting were the characteristic added toxicities.
Zolbetuximab with either FOLFOX or CAPOX is a first-line standard for claudin 18.2-positive, HER2-negative gastric cancer, making claudin 18.2 testing routine.