OnCo
pairingsPairing

CLDN18.2 antibody first line → CLDN18.2 ADC or CAR-T on progression

Hit Claudin 18.2 twice: first with a plain antibody plus chemotherapy, then with an ADC or engineered cells when the cancer comes back.

Zolbetuximab + chemotherapy is approved first line; CLARITY-Gastric 01 showed an OS benefit for the CLDN18.2 ADC sonesitatug vedotin in later lines (July 2026); satri-cel CAR-T is approved in China. Whether prior zolbetuximab reduces ADC benefit (antigen persistence, ADCC-selected clones) is the key unknown.

Zolbetuximab→ thenSonesitatug vedotinsequence
Rationale
CLDN18.2 is a lineage antigen that tends to persist; the three modalities kill by different mechanisms (ADCC/CDC, payload, T cells).
Evidence
Phase 3 for each agent individually; sequencing data pending.

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cancers

1
Gastric & gastro-oesophageal junction cancer

targets

1
Claudin 18.2

drugs

3
Under reviewCAR-T (Claudin 18.2)
Satricabtagene autoleucel
Phase 3ADC
Sonesitatug vedotin
ApprovedMonoclonal antibody (anti-Claudin 18.2)
Zolbetuximab · Vyloy

trials

2
CLARITY-Gastric 01SPOTLIGHT & GLOW