Comparative efficacy of CLDN18.2-directed regimens in advanced gastric/gastroesophageal junction adenocarcinoma: a meta-analysis of single-arm trials.
Yue Yuan, Hongkai Yan, Qinhang Wu
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In 30 seconds
This meta-analysis pooled results from 10 single-arm trials involving 710 patients with advanced gastric or gastroesophageal junction adenocarcinoma treated with CLDN18.2-directed regimens. Across regimens, pooled objective response rate was 30.3% (95% CI 14.8%-48.1%), disease control rate was 78.5% (95% CI 61.2%-92.1%), and median progression-free survival was 4.19 months (95% CI 2.90-5.49). Outcomes varied by treatment: zolbetuximab plus chemotherapy had higher pooled activity than zolbetuximab alone, while CAR-T findings were based on one study.
Key findings
- Zolbetuximab plus chemotherapy had pooled mPFS of 6.61 months, ORR of 63.7%, and DCR of 95.6%.
- Zolbetuximab monotherapy had pooled mPFS of 1.84 months, ORR of 4.8%, and DCR of 37.9%.
- In pretreated patients, ADCs had pooled mPFS of 5.31 months, ORR of 36.7%, and DCR of 84.3%.
- CAR-T therapy had pooled mPFS of 5.80 months, ORR of 54.2%, and DCR of 96.1%, based on a single study.
Why it matters
The pooled results suggest that efficacy differs substantially among CLDN18.2-directed approaches, rather than representing a uniform treatment effect. They provide a comparative overview of response and disease-control outcomes across regimens and treatment settings, while highlighting that evidence for some approaches is less mature. These estimates can inform interpretation of the emerging evidence but do not establish comparative superiority.
What to keep in mind
All included evidence came from single-arm trials, limiting direct comparisons between regimens. CAR-T estimates were based on a single study.