Claudin18.2 in Advanced Gastric Cancer

Simple Summary Gastric cancer (GC) is one of the most common and deadly cancers globally, rendering the development of novel therapeutic strategies an urgent priority. Recently, zolbetuximab, which targets and binds to the transmembrane protein claudin 18 isoform 2 (CLDN18.2). has emerged as a new target therapy in the treatment of advanced GC (AGC). In this review, the molecular and immunological profile of CLDN18.2 in AGC, the results of recent clinical trials, and ongoing clinical trials for patients with CLDN18.2 expressed AGC, and solid tumors were elucidated.Abstract Globally, the fifth most common cancer and the fourth leading cause of cancer-related mortality is gastric cancer (GC). Recent clinical trials on solid tumors enrolled patients who possess druggable genetic alterations, protein expression, and immune characteristics. In gastric or gastroesophageal junction (GEJ) cancers, trastuzumab combined with first-line chemotherapy in human epidermal growth factor receptor 2 (HER2)-positive patients and ramucirumab combined with second-line paclitaxel remarkably prolonged overall survival (OS) compared with chemotherapy alone, according to phase 3 trial results. Recently, immune checkpoint inhibitor (ICI) monotherapy was approved as third- or later-line treatment. Chemotherapy plus ICIs as first-line treatment exhibited improved survival compared with chemotherapy alone in HER2-negative patients according to Checkmate 649 trial results. Conversely, systemic chemotherapy prognosis remains poor. although some patients may achieve durable response to treatment and prolonged survival in advanced GC. Recently, a first-in-class, chimeric immunoglobulin G1 monoclonal antibody (zolbetuximab) that targets and binds to claudin 18 isoform 2 (CLDN18.2) has emerged as a new target therapy in GC treatment. Global phase III trials revealed that the addition of zolbetuximab to first-line chemotherapy prolonged OS in CLDN18.2-positive and HER2-negative GC patients. This review summarizes recent clinical trials of CLDN18.2-targeted therapy.