CLDN18.2-positive, HER2-negative advanced/metastatic gastric or GEJ adenocarcinoma — Astellas Pharma
Discover KOL Sentiment on ILUSTRO →Design - Phase 2 signal-finding study of zolbetuximab (Vyloy, anti-CLDN18.2) mono/combinations in CLDN18.2+ HER2- gastric/GEJ adenocarcinoma (NCT03505320); featured Cohort 4B triplet = zolbetuximab + mFOLFOX6 + nivolumab (n=71).
PFS (Cohort 4B) - Median PFS 14.8 mo (95% CI 8.3-NE); ORR 62.1%; median duration of response 19.1 mo - single-arm Phase 2 signal.
OS - Immature - not estimable in the CLDN18.2-high subgroup; intermediate-expression subgroup median OS 9.6 mo.
Safety - Grade >=3 rates not yet detailed; consistent with individual agents - zolbetuximab GI toxicity (nausea, vomiting) plus chemotherapy + nivolumab profile.
Regulatory - Vyloy (zolbetuximab) FDA approved Oct 18, 2024 WITH CHEMO in 1L CLDN18.2+ gastric/GEJ; the ILUSTRO triplet (adds nivolumab) is INVESTIGATIONAL, supporting Phase 3 LUCERNA.
Sponsor / drug - Astellas Pharma; zolbetuximab (Vyloy) + mFOLFOX6 + nivolumab (Opdivo).
Compiled and reviewed by the KOL Pulse research team, led by Brian Shields, Founder, KOL Pulse. Last updated July 21, 2026.
Top tweets by impressions — click to view on X
Conf Highlights #GI26 from #CommunityOnc:
1. #HerizonGEA01 Her2 GEJ/Gastric
2. #ILUSTRO Cldn18.2 GEJ/Gastric
3. #GALAXY ctDNA Rectal Ca
4. #BREAKWATER BRAFV600E mCRC
5. #COMMIT dMMR/MSI…
🚨 CLDN18.2 at #ASCOGI26
ILUSTRO Cohort 4B delivers a strong signal 👀
🧬 Triplet: Zolbetuximab + mFOLFOX6 + Nivolumab
📍 1L HER2-, CLDN18.2+ advanced gastric / GEJ
📈 Key efficacy
⏱️ Median PFS 14.8…
LBA284: ILUSTRO4 from @KoheiShitara with Zolbetuximab + FOLFOX + Nivo in met #gastroesophageal #cancer with encouraging
👉PFS of 18M vs. 6.7M in cohort of 4B
👉ORR = 62.1%
👉Next: Phase III…
Impressive data from ILUSTRO (#GI26 LBA284) @KoheiShitara
Ph2 1L Zolbe + Nivo + FOLFOX in CLDN18.2+ GEA
mPFS results (cohort 4B, n = 71)
◾️Overall: 14.8 mo
◾️CLDN18.2 High vs Intermediate: 18.0 vs…
#GI26 🧪🍽️ ILUSTRO Cohort 4B (phase II) | 1L CLDN18.2+ GC/GEJ
➕ zolbe + mFOLFOX6 + nivo
📈 mPFS: 14.8 mo overall; 18.0 mo in CLDN18.2-high
🎯 ORR: 62.1% overall; 68.1% in CLDN18.2-high
🧬 Greater benefit…
#GI26
🔹Ilustro trial 1L Zolbe+Nivo +mfolfox in pts with CLD18.2 +locally advanced G/GEJ adenocarcinoma https://t.co/xYNJkAz7hm
💡 ILUSTRO phase 2 (Cohort 4B): zolbetuximab + mFOLFOX6 + nivolumab in CLDN18.2+ G/GEJ adenocarcinoma #ASCOGI26
🎯 Median PFS: 14.8 months
▪️CLDN18.2-high mPFS 18.0 vs 6.7 mo…
ASCO GI2026 胃癌領域についてAIでまとめてめた。
参考までに確認!
#ASCOGI2026 胃癌(Gastric/GEJ)主要結果
1.CLDN18.2陽性・HER2陰性進行胃/GEJ癌
zolbetuximab+化学療法:OS中央値 約18か月、PFS 約10–11か月
2.CLDN18.2高発現集団
低発現より OS・PFS改善幅が大
3.MSI-H胃癌
免疫療法で
ILUSTRO phs-2: 1L zolbetuximab + mFOLFOX6 + nivo in CLDN18.2+ G/GEJ adenocarcinoma
#ASCOGI26
👉 all vs CLDN18.2 high
👉 ORR: 62 vs 68%
👉 mPFS: 14.8 vs 18 mo
🧐 Interesting activity in CLDN18.2 high,…
Zolbetuximab plus Chemo plus IO . Phase 2 data ILUSTRO trial.
Looks promising @ASCO #ASCOGI26 @OncoAlert https://t.co/aIx3qPDLMt
ILUSTRO Cohort 4B provides phase 2 signal supporting triplet therapy (zolbetuximab + mFOLFOX6 + nivolumab) in CLDN18.2+ gastric/GEJ. mPFS 14.8 mo and ORR 62.1% are encouraging. Supports phase 3 development (LUCERNA: zolbetuximab + pembrolizumab + chemo). Does not change current label; monotherapy/chemo combination remains the standard per SPOTLIGHT/GLOW.
Cohort 4B (n=71) — zolbetuximab + mFOLFOX6 + nivolumab triplet: median PFS 14.8 months (95% CI 8.3-NE), ORR 62.1%, median duration of response 19.1 months (95% CI 10.8-NE). Single-arm phase 2 signal supporting further development.
OS data immature; median OS not estimable in CLDN18.2-high subgroup. Intermediate-expression subgroup: median OS 9.6 months (95% CI 5.4-NE). Full OS analysis pending longer follow-up.
Grade ≥3 AE rates not yet detailed in available abstracts. Safety consistent with individual agents — zolbetuximab GI toxicity (nausea, vomiting) plus expected chemotherapy + nivolumab profile.
⚠️ Phase 2 signal supporting triplet development. ILUSTRO Cohort 4B provides phase 2 signal supporting triplet therapy (zolbetuximab + mFOLFOX6 + nivolumab) in CLDN18.2+ gastric/GEJ. mPFS 14.8 mo and ORR 62.1% are encouraging. Supports phase 3 development (LUCERNA: zolbetuximab + pembrolizumab + chemo). Does not change current label; monotherapy/chemo combination remains the standard per SPOTLIGHT/GLOW.
ILUSTRO is a Phase 2 multi-cohort signal-finding study (NCT03505320) of zolbetuximab (Vyloy, an anti-CLDN18.2 monoclonal antibody) as monotherapy and in combinations for CLDN18.2-positive, HER2-negative advanced or metastatic gastric or gastroesophageal junction adenocarcinoma. The most-discussed cohort, 4B, tests the triplet of zolbetuximab plus mFOLFOX6 chemotherapy plus nivolumab in 71 patients.
In Cohort 4B (n=71), the zolbetuximab + mFOLFOX6 + nivolumab triplet produced a median progression-free survival of 14.8 months (95% CI 8.3-NE), an objective response rate of 62.1%, and a median duration of response of 19.1 months. These are encouraging single-arm Phase 2 signals; overall survival data remain immature.
Yes, but not for the ILUSTRO triplet. On October 18, 2024 the FDA approved zolbetuximab (Vyloy) in combination with fluoropyrimidine- and platinum-based chemotherapy for first-line CLDN18.2-positive, HER2-negative locally advanced unresectable or metastatic gastric/GEJ adenocarcinoma (based on SPOTLIGHT and GLOW). The ILUSTRO Cohort 4B regimen adds nivolumab and is investigational, not covered by that approval.
Claudin-18.2 (CLDN18.2) is a tight-junction protein expressed in a subset of gastric and gastroesophageal junction cancers. Zolbetuximab targets CLDN18.2, so patients must have CLDN18.2-positive tumors (by an appropriate assay) to be candidates. ILUSTRO enrolls CLDN18.2-positive, HER2-negative disease.
The encouraging Cohort 4B signal supports further, larger development. The triplet strategy is moving into Phase 3 evaluation (the LUCERNA program). Until randomized Phase 3 data are available, the zolbetuximab-plus-nivolumab-plus-chemotherapy combination remains investigational.