Zolbetuximab Plus CAPOX Improves Survival in Gastric/Gastroesophageal Junction Cancers

Results From the GLOW Trial

According to results from the GLOW study, first-line zolbetuximab in combination with chemotherapy extends survival in patients with claudin-18.2-positive/HER2-negative locally advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma. 

Lead author of this study, Rui-Hua Xu, MD, PhD, Sun Yat-sen University Cancer Center, Guangzhou, China, and colleagues presented GLOW trial results during the March 2023 session of the ASCO Plenary Series. Previously, the SPOTLIGHT trial reported better (progression-free survival) PFS and overall survival (OS) within this patient population with zolbetuximab plus folic acid, 5-FU, and oxaliplatin (mFOLFOX6), compared with placebo and mFOLFOX6.

While platinum/fluoropyrimidine chemotherapy is one of the standard first-line treatments for these patients, there are no agreed-upin guidelines available on a particular regimen that should be used in clinical practice. Therefore, investigators in there trials selected standard approved chemotherapy regimens used globally in combination with zolbetuximab: mFOLFOX6 in the SPOTLIGHT trial and capecitabine plus oxaliplatin (CAPOX) in the GLOW trial.

In the GLOW study, 507 patients were randomized on a 1-to-1 basis to receive zolbetuximab along withCAPOX or placebo with CAPOX. After  cycles , patients continued with either zolbetuximab or placebo, plus capecitabine, until disease progression or a discontinuation criteria was met. 

Median PFS was 8.2 months in the zolbetuximab arm compared with 6.8 months in the placebo arm. Median OS was 14.39 months in the zolbetuximab arm compared to 12.1 months in the placebo arm. 

Dr Xua concluded, “The results of GLOW and SPOTLIGHT [trials] suggest that zolbetuximab plus chemotherapy has the potential to be an innovative therapeutic option and a potential new standard of care for patients with [caludin]18.2-positive, HER2-negative, locally advanced unresectable or metastatic gastric/GEJ adenocarcinoma.”

Source:

Zolbetuximab plus CAPOX improves survival in certain gastric cancers. ASCO. Published online March 21, 2023. https://old-prod.asco.org/about-asco/press-center/news-releases/zolbetuximab-plus-capox-improves-survival-certain-gastric?cid=DM13102&bid=254661113 

Xu R, Shitara K, Ajani JA, et al. Zolbetuximab + CAPOX in 1L claudin-18.2+ (CLDN18.2+)/HER2− locally advanced (LA) or metastatic gastric or gastroesophageal junction (mG/GEJ) adenocarcinoma: Primary phase 3 results from GLOW. Presented at ASCO Plenary Series; March 22, 2023; Virtual. doi:10.1200/JCO.2023.41.36_suppl.405736