{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:42:42Z","timestamp":1792665762700,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Claudin 18.2 (CLDN18.2) is a promising therapeutic target in gastric\/esophagogastric junction adenocarcinoma (GC\/EGJC), but its dynamic expression during systemic therapy is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CLDN18.2 expression by immunohistochemistry in paired tumor samples from 155 patients with advanced GC\/EGJC was retrospectively evaluated before and after systemic therapy. CLDN18.2\u2010positive was defined as \u226575% of viable tumor cells exhibiting moderate\u2010to\u2010strong (2+ or 3+) membranous staining.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among all patients, 54 (34.84%) were CLDN18.2\u2010positive. Following treatment, the proportion of CLDN18.2\u2010positive patients increased significantly to 61 (39.35%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). Among patients who were CLDN18.2\u2010negative at baseline, 57 (56.44%) showed increased expression after treatment, including 22 (21.78%) who converted to positive status. In contrast, among those CLDN18.2\u2010positive at baseline, expression decreased in 35 patients (64.81%), with 15 (27.78%) converting to negative status (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). Among patients receiving chemotherapy alone (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a025), 1 (4.00%) converted to negative and 5 (20.00%) converted to positive, whereas among those receiving chemotherapy combined with immunotherapy (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0130), 14 (10.77%) converted to negative and 17 (13.08%) converted to positive (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.45). A total of 131 patients (84.52%) demonstrated changes in CLDN18.2 expression following therapy, encompassing both conversions across the positivity threshold and fluctuations within the same classification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CLDN18.2 expression in GC\/EGJC is dynamic and frequently altered after systemic therapy. These findings support reassessment of CLDN18.2 status before initiating CLDN18.2\u2010targeted therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70632","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:51:21Z","timestamp":1791442281000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic changes of claudin 18.2 expression after systemic therapy in gastric and esophagogastric junction cancer"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4866-9864","authenticated-orcid":false,"given":"Danni","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Gastric Surgery Zhejiang Cancer Hospital  Hangzhou China"},{"name":"Wenzhou Medical University  Wenzhou 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