Gastric cancer (GC) remains a formidable global health challenge, ranking among the top-five causes of cancer-related deaths worldwide. The majority of patients face advanced stages at diagnosis, with a mere 6% five-year survival rate. First-line treatment for metastatic GC typically involves a fluoropyrimidine and platinum agent combination; yet, predictive molecular markers have proven elusive. This review navigates the evolving landscape of GC biomarkers, with a specific focus on Claudin 18.2 (CLDN18.2) as an emerging and promising target. Recent phase III trials have unveiled the efficacy of Zolbetuximab, a CLDN18.2-targeting antibody, in combination with oxaliplatin-based chemotherapy for CLDN18.2-positive metastatic GC. As this novel therapeutic avenue unfolds, understanding the nuanced decision making regarding the selection of anti-CLDN18.2 therapies over other targeted agents in metastatic GC becomes crucial. This manuscript reviews the evolving role of CLDN18.2 as a biomarker in GC and explores the current status of CLDN18.2-targeting agents in clinical development. The aim is to provide concise insights into the potential of CLDN18.2 as a therapeutic target and guide future clinical decisions in the management of metastatic GC.
胃癌仍是全球健康领域的重大挑战，其死亡率位居全球癌症相关死因前五位。多数患者在确诊时已处于晚期阶段，五年生存率仅为6%。转移性胃癌的一线治疗通常采用氟尿嘧啶类与铂类药物的联合方案，然而有效的预测性分子标志物至今尚未明确。本文系统梳理了胃癌生物标志物研究的最新进展，特别聚焦于紧密连接蛋白18.2（CLDN18.2）这一新兴潜力靶点。近期III期临床试验证实，靶向CLDN18.2的单克隆抗体Zolbetuximab联合奥沙利铂化疗方案对CLDN18.2阳性转移性胃癌具有显著疗效。随着这一创新治疗路径的展开，深入理解在转移性胃癌治疗中选择抗CLDN18.2疗法而非其他靶向药物的精细化决策机制至关重要。本文综述了CLDN18.2作为胃癌生物标志物的演进历程，探讨了靶向CLDN18.2药物在临床研发中的现状，旨在为CLDN18.2作为治疗靶点的潜力提供精要见解，并为转移性胃癌的临床决策提供前瞻性指导。
Claudin 18.2 as a New Biomarker in Gastric Cancer—What Should We Know?
肿瘤(癌症)患者之家