Gastric Cancer Research Reveals New Insights on Zolbetuximab-Induced Gastritis

Researchers at the National Cancer Center Hospital East in Chiba, Japan, have made significant discoveries regarding the adverse effects of zolbetuximab, a monoclonal antibody used in the treatment of CLDN18.2-positive advanced gastric cancer. The study, published in ESMO Open, highlights the incidence and characteristics of gastritis in patients undergoing first-line zolbetuximab-containing chemotherapy.

Key Takeaways:

• Gastritis was observed in 89.7% of patients at a median of 7.8 weeks after treatment initiation, with characteristic endoscopic findings including mucosal erythema, white exudate, edema, and erosions or ulcerations.
• The distribution of gastritis was predominantly diffuse (76.9%) rather than scattered (23.1%), commonly involving multiple gastric regions (90.4%).
• Patients with diffuse gastritis experienced significantly higher rates of anorexia (97.5% versus 50.0%, P = 0.005) and more profound serum albumin decline [median decrease -1.2 g/dl, interquartile range (IQR) -1.525 to -0.9 g/dl versus -0.7 g/dl, IQR -0.8 to -0.6 g/dl; P = 0.012] compared to those without gastritis.
• No patients discontinued treatment due to gastritis, and improvement was confirmed in 25 out of 32 patients who underwent follow-up endoscopy during ongoing treatment.

Statistics:

• 58 patients were eligible for the study.
• Gastritis was observed in 52 (89.7%) patients at a median of 7.8 weeks after treatment initiation.
• Characteristic endoscopic findings included 100% mucosal erythema, 63.4% white exudate, 28.8% edema, and 26.9% erosions or ulcerations.
• 76.9% of gastritis cases were diffuse rather than scattered, and 90.4% involved multiple gastric regions.
• 97.5% of patients with diffuse gastritis experienced anorexia.
• Median serum albumin decline was -1.2 g/dl (IQR -1.525 to -0.9 g/dl).
• 25 out of 32 patients showed improvement in gastritis during follow-up endoscopy.

Sources:

• ESMO Open: "Characterization of early-onset gastritis during zolbetuximab-containing chemotherapy in CLDN18.2-positive gastric cancer"
• National Cancer Center Hospital East: Y. Owaki et al., Dept. of Gastroenterology and Endoscopy
• Elsevier: ESMO Open, Radarweg 29, 1043 Nx Amsterdam, Netherlands