# GLOW: zolbetuximab plus CAPOX in claudin 18.2-positive, HER2-negative gastric or gastro-oesophageal junction adenocarcinoma

Source: https://onco.cc/key-papers/paper-glow-zolbetuximab-nat-med-2023/  
OnCo record `paper-glow-zolbetuximab-nat-med-2023` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding the claudin 18.2 antibody zolbetuximab to CAPOX chemotherapy lengthened survival in claudin 18.2-positive advanced gastric cancer, confirming the SPOTLIGHT result with a different chemotherapy backbone.

## Summary

Phase 3 placebo-controlled trial of 507 patients with untreated claudin 18.2-positive (75 percent or more of tumour cells), HER2-negative locally advanced or metastatic gastric or junctional adenocarcinoma randomised to zolbetuximab or placebo with capecitabine and oxaliplatin.

Median progression-free survival was 8.21 versus 6.80 months (hazard ratio 0.687) and median overall survival 14.39 versus 12.16 months (hazard ratio 0.771); nausea and vomiting were the characteristic added toxicities.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Nature Medicine
- Year: 2023
- DOI: 10.1038/s41591-023-02465-7
- Authors: Shah MA, Shitara K, Ajani JA, et al.
- Findings: Median overall survival 14.39 vs 12.16 months; hazard ratio 0.771.; Median progression-free survival 8.21 vs 6.80 months.
- What it means: Zolbetuximab with either FOLFOX or CAPOX is a first-line standard for claudin 18.2-positive, HER2-negative gastric cancer, making claudin 18.2 testing routine.
- Caveats: About 38 percent of screened patients were claudin 18.2-positive.; Nausea and vomiting in the first cycles lead to some discontinuation.

## Sources

- Nat Med 2023: https://doi.org/10.1038/s41591-023-02465-7
- PubMed: https://pubmed.ncbi.nlm.nih.gov/37524953/

## Connected records

- cancers: [Claudin 18.2-positive gastric cancer](https://onco.cc/cancers/gastric-cldn18-2-positive/)
- drugs: [Zolbetuximab](https://onco.cc/drugs/zolbetuximab/)
- journals: [Nature Medicine](https://onco.cc/journals/nature-medicine/)

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