Health-related quality of life in patients with CLDN18.2-positive, locally advanced unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma: results from the SPOTLIGHT and GLOW clinical trials

• Published in: ESMO open Vol. 9; no. 8; p. 103663
• Main Authors: Lordick, F., Van Cutsem, E., Shitara, K., Xu, R.-H., Ajani, J.A., Shah, M.A., Oh, M., Ganguli, A., Chang, L., Rhoten, S., Bhattacharya, P., Matsangou, M., Park, J.W., Pophale, R., Ranganath, R., Kang, Y.-K.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2024; Elsevier
• Subjects: Adenocarcinoma - drug therapy; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Claudins; CLDN18.2; Esophageal Neoplasms - drug therapy; Esophagogastric Junction - pathology; Female; Fluorouracil - therapeutic use; gastric adenocarcinoma; gastroesophageal junction adenocarcinoma; Humans; Leucovorin - therapeutic use; Male; Middle Aged; Organoplatinum Compounds - therapeutic use; Original Research; Patient Reported Outcome Measures; patient-reported outcomes; Quality of Life; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Surveys and Questionnaires; zolbetuximab; patient-reported outcomes; CLDN18.2; gastric adenocarcinoma; gastroesophageal junction adenocarcinoma; quality of life; zolbetuximab
• ISSN: 2059-7029; 2059-7029
• DOI: 10.1016/j.esmoop.2024.103663

First-line zolbetuximab plus chemotherapy (SPOTLIGHT, mFOLFOX6; GLOW, CAPOX) significantly improved progression-free survival (PFS) and overall survival (OS) versus placebo plus chemotherapy in patients with human epidermal growth factor receptor 2-negative, locally advanced unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma whose tumors were claudin 18 isoform 2-positive in the phase III SPOTLIGHT (NCT03504397) and GLOW (NCT03653507) studies. We present patient-reported outcomes (PROs) from these studies. Health-related quality of life (HRQoL) was measured in the full analysis sets using the European Organisation for Research and Treatment of Cancer Quality of Life of Cancer Patients Core Questionnaire (QLQ-C30) and Oesophago-Gastric Module (QLQ-OG25), Global Pain, and 5-level EQ-5D (EQ-5D-5L) questionnaires. Analyses focused on key PRO domains: global health status (GHS)/QoL, physical functioning, abdominal pain and discomfort, and nausea/vomiting. Least squares mean (LSM) changes from baseline and time to first definitive deterioration (TTDD) were evaluated combined across SPOTLIGHT and GLOW and for individual studies. Time to confirmed deterioration (TTCD) was evaluated independently for SPOTLIGHT and GLOW. The combined analysis set included 1072 patients (zolbetuximab plus chemotherapy, 537; placebo plus chemotherapy, 535). Compliance rates were similar between treatment arms. Similar trends were observed in the zolbetuximab versus placebo arms for LSM changes from baseline in key PRO domains, with no clinically meaningful deterioration. Nausea/vomiting worsened during the first few zolbetuximab cycles but later returned to baseline levels. Overall TTCD and TTDD results were similar between arms in both studies. Patients in SPOTLIGHT and GLOW maintained measured HRQoL relative to baseline when treated with first-line zolbetuximab added to chemotherapy. Zolbetuximab plus chemotherapy improved PFS and OS without negatively affecting HRQoL in key PRO domains compared with placebo plus chemotherapy. •Key PRO domains of interest were GHS/QoL, physical functioning, abdominal pain and discomfort, and nausea/vomiting.•In SPOTLIGHT and GLOW combined, there were no clinically meaningful changes from baseline with zolbetuximab + chemotherapy.•Change from baseline trends for key PRO domains were similar with zolbetuximab + chemotherapy and placebo + chemotherapy.•Nausea/vomiting worsened in early cycles but later returned to baseline levels without clinically meaningful deterioration.•Zolbetuximab + chemotherapy improved PFS and OS without negatively affecting HRQoL compared with placebo + chemotherapy.