ReviewInvestigational new drugs2026
Comparative efficacy of CLDN18.2-directed regimens in advanced gastric/gastroesophageal junction adenocarcinoma: a meta-analysis of single-arm trials.
Review in Investigational new drugs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
objectiveTo compare the efficacy and safety of different Claudin (CLDN)18.2-directed regimens in advanced gastric/gastroesophageal junction adenocarcinoma.
methodsPubMed, Web of Science, CNKI, and Wanfang databases were searched up to June 2026. Single-arm trials evaluating CLDN18.2-targeted gastric/gastroesophageal junction adenocarcinoma therapies were included. Meta-analysis was performed to pool objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), and safety outcomes.
resultsTen studies (710 patients) were included. The pooled mPFS was 4.19 months (95% CI 2.90-5.49), the pooled ORR was 30.3% (95% CI 14.8%-48.1%), and the pooled DCR was 78.5% (95% CI 61.2%-92.1%). Subgroup analyses by treatment type revealed substantial efficacy differences. Zolbetuximab monotherapy showed limited activity (mPFS 1.84 months, ORR 4.8%, DCR 37.9%), which improved markedly when combined with chemotherapy (mPFS 6.61 months, ORR 63.7%, DCR 95.6%). Antibody-drug conjugates (ADCs) achieved notable efficacy in pretreated patients (mPFS 5.31 months, ORR 36.7%, DCR 84.3%). Chimeric antigen receptor T-cell (CAR-T) therapy demonstrated substantial anti-tumor activity (mPFS 5.80 months, ORR 54.2%, DCR 96.1%), but the evidence was based on a single study and should be considered preliminary.
conclusionZolbetuximab plus chemotherapy is the preferred strategy for patients eligible for chemotherapy. ADCs represent a viable option for patients with chemotherapy resistance or intolerance. Zolbetuximab monotherapy has limited efficacy and should be used sparingly. CAR-T showed promising activity but remains investigational.
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