New frontiers in the treatment of stomach cancer
When Research Opens the Door to Hope
The treatment of stomach cancer is entering a new era thanks to innovative discoveries that promise to significantly improve patient survival and quality of life. This article explores the latest advancements, with a particular focus on the targeted treatment zolbetuximab, and provides a glimpse into the future of gastric cancer therapy.
The Rise of Targeted Therapy
Research in stomach cancer has made tremendous strides with the introduction of targeted therapies, such as zolbetuximab, a monoclonal antibody that holds promise for patients with HER2-negative tumors expressing high levels of CLDN 18.2. This protein, normally present in gastric mucosal cells, becomes more exposed with the development of stomach cancer, offering a therapeutic target. The current standard treatment for these patients is limited to chemotherapy, with an average survival of about 12 months. However, the GLOW study has demonstrated that adding zolbetuximab to standard chemotherapy can significantly reduce the risk of disease progression or death, extending median survival to 14.4 months compared to 12.2 months in the placebo group.
Promising Results from Clinical Trials
Phase 3 of the international clinical trial GLOW, conducted with 507 patients in 18 countries, revealed that zolbetuximab, in combination with CAPOX chemotherapy, improved progression-free survival and doubled the chance of no disease progression at 2 years. Furthermore, this treatment significantly extended overall survival and reduced the risk of death by 23%, without adding significant toxicity to the treatment regimen.
The Path to Personalized Care
This discovery marks a significant step toward personalized stomach cancer treatment, offering patients the opportunity to choose, in consultation with their doctors, the most suitable therapeutic regimen. If approved, zolbetuximab will become the first targeted therapy in the United States for patients with advanced HER2-negative gastric or gastroesophageal junction cancer expressing CLDN 18.2.
In addition to zolbetuximab, other chemotherapy regimens, such as FLOT and SOX, continue to be the backbone of perioperative treatment in many countries, showing improvements in survival for patients with stage II or III stomach cancer. Research also continues in the areas of chemoradiotherapy and adjuvant chemotherapy, with the aim of identifying the most effective treatments based on the individual characteristics of the tumor and the patient.