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Cancer reports
By Mizuno T, Narita Y, Ando T and 9 others.
Hypoalbuminemia has been recognized as a characteristic adverse event associated with zolbetuximab plus chemotherapy in the treatment of claudin 18.2-positive advanced gastric cancer. However, its incidence, clinical predictors, and management in real-world settings remain unclear.
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We aimed to characterize the course of hypoalbuminemia during zolbetuximab-based therapy and identify factors associated with its severity and recovery. Methods and results: We retrospectively analyzed patients with advanced gastric cancer treated with zolbetuximab plus chemotherapy at a single center, tracking serial serum albumin levels. Severe hypoalbuminemia was defined as a nadir albumin < 2.0 g/dL and/or a ≥ 1.0 g/dL decrease from baseline. Associations between severe hypoalbuminemia and clinicopathological factors were assessed, along with its management strategies. A total of 39 patients were included in the analysis. Hypoalbuminemia occurred in all patients, and 20 (51.3%) developed severe hypoalbuminemia. Prior total gastrectomy was associated with a lower incidence of severe hypoalbuminemia (0% vs. 58.8%, p = 0.02), whereas persistent nausea and/or vomiting beyond the zolbetuximab infusion during the first cycle was associated with a higher risk (63.0% vs. 25.0%, p = 0.04). Recovery of serum albumin levels was observed in 18 patients (46.2%) and occurred more frequently among those who temporarily interrupted zolbetuximab plus chemotherapy or zolbetuximab alone (66.7% vs. 28.6%, p = 0.03).
Severe hypoalbuminemia was common in patients receiving zolbetuximab plus chemotherapy in real-world practice. The absence of prior total gastrectomy and the presence of persistent post-infusion nausea and/or vomiting may help identify patients at risk. The observed association between temporary treatment interruption and albumin recovery may provide insights into the management of hypoalbuminemia.
Published in Cancer reports (Hoboken, N.J.). The abstract is shown as published and remains the work of its authors; read the full article at the source.
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