Symptom Burden and Healthcare Resource Use in Patients With Claudin 18.2-Positive, HER2-Negative, Locally Advanced Unresectable or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma: A Retrospective Review
Clinical Medicine Insights: Oncology, 2026
Background
Control of disease-related symptoms is a goal of chemotherapy for patients with locally advanced (LA) unresectable or metastatic gastric/gastroesophageal junction (mG/GEJ) adenocarcinoma. This study describes disease-related symptoms and healthcare resource utilization (HRU) in this population.
Methods
A retrospective review of adult patients with claudin 18.2-positive (CLDN18.2+), human epidermal growth factor receptor 2-negative (HER2-), LA unresectable or mG/GEJ adenocarcinoma was performed. Outcomes were assessed from the index date (date of diagnosis) through the follow-up end date (earliest of first-line treatment discontinuation, last follow-up visit, death, or 1 year after index date).
Results
Sixty-two patients were included in the analysis (mean age, 61.3 years; 54.8% male; 88.7% White; 67.7% had gastric primary tumors; 75.8% had peritoneal metastases; 98.4% received first-line treatment [mean time from diagnosis to treatment initiation, 37.0 days]). All patients reported ⩾1 disease-related symptom (mean = 7.2) at the index date. The most common symptoms at the index date were weight loss (74.2%), abdominal pain/stomach pain (66.1%), anemia/weakness (61.3%), poor appetite (56.5%), and epigastric pain (50.0%). Of the 21 patients evaluated at the 6-month follow-up, 95.2% reported ⩾1 disease-related symptom. The greatest changes were seen for weight loss (0.0% at 6 months vs 74.2% at the index date), epigastric pain (9.5% vs 50.0%), poor appetite (23.8% vs 56.5%), reflux (4.8% vs 35.5%), early satiety (0.0% vs 29.0%), and abdominal pain/stomach pain (38.1% vs 66.1%). A mean of 3.4 outpatient visits per patient per month was reported (mean follow-up, 6.5 months), 21.0% of patients had an inpatient admission, and 35.5% had an emergency department visit.
Conclusions
This study demonstrates substantial disease-related symptom burden and high HRU for patients with CLDN18.2+, HER2-, LA unresectable or mG/GEJ adenocarcinoma.
Authors
Sewastjanow-Silva M, Oh M, Chang L, Ganguli A, Rogers JE, Waters RE, Rosa Vicentini E, Yamashita K, Totev TI, Wu EQ, Yang H, Iwata K, Ajani JA