Evidence map›Paper›PMID 42189319›Full record

ArticleJournal of gastrointestinal cancer2026

Surgical Intervention After Zolbetuximab-Based Chemotherapy for CLDN18.2-Positive Gastric and Gastroesophageal Junction Adenocarcinoma: A Case Series.

Shutaro Oiwa, Tamotsu Sagawa, Hayato Watabe, Masahiro Hirakawa, Atsushi Uesugi, Makoto Yoshida, Hiroyuki Nagashima, Koshi Fujikawa

Abstract readCase Reports
PubMed Publisher
In one paragraph

Article in Journal of gastrointestinal cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shutaro OiwaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Tamotsu SagawaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan. stamotsu@jk9.so-net.ne.jp.
Hayato WatabeDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Masahiro HirakawaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Atsushi UesugiDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Makoto YoshidaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Hiroyuki NagashimaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.
Koshi FujikawaDepartment of Gastroenterology, National Hospital Organization Hokkaido Cancer Center, 3-54 Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo-shi, Hokkaido, 003-0804, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundZolbetuximab, a monoclonal antibody targeting claudin-18 isoform 2 (CLDN18.2), has demonstrated survival benefits when combined with platinum-based chemotherapy in patients with CLDN18.2-positive gastric and gastroesophageal junction (GEJ) adenocarcinoma. However, evidence regarding surgical intervention following zolbetuximab-based chemotherapy remains limited. CASE PRESENTATION: We report four patients with CLDN18.2-positive, HER2-negative gastric or GEJ adenocarcinoma who underwent surgical intervention following zolbetuximab-based chemotherapy. Three patients initially had unresectable or marginally resectable disease and subsequently underwent conversion-intent or response-adapted surgical intervention after tumor regression and improvement of non-curative factors. One patient underwent pulmonary metastasectomy for metachronous oligometastatic disease after sustained systemic disease control. Zolbetuximab was administered in combination with mFOLFOX6 or CAPOX for a median of seven cycles. Macroscopic complete resection was achieved in three patients, whereas one patient had microscopic residual disease. No unexpected perioperative complications attributable to zolbetuximab were observed. These findings suggest that zolbetuximabbased chemotherapy may allow surgical intervention in carefully selected patients; however, the survival benefit of this approach remains unproven and requires further study.

conclusionsZolbetuximab-based chemotherapy may facilitate conversion-intent or response-adapted surgical intervention, including metastasectomy, in carefully selected patients with CLDN18.2-positive gastric and GEJ adenocarcinoma. A biomarker-driven, response-adapted multidisciplinary strategy may help identify candidates for surgery following CLDN18.2-targeted therapy, but larger studies are required to determine whether this approach improves survival outcomes.

Indexed as

AdenocarcinomaAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsClaudinsEsophageal NeoplasmsStomach NeoplasmsAgedAntibodies, MonoclonalEsophagogastric JunctionFemaleFluorouracilHumansMaleMiddle AgedOrganoplatinum CompoundsAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedClaudinsCLDN18 protein, humanFluorouracilOrganoplatinum CompoundszolbetuximabCLDN18.2Conversion-intent surgeryGastric cancerGastroesophageal junction cancerResponse-adapted surgeryZolbetuximab

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.