{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:12:29Z","timestamp":1778562749065,"version":"3.51.4"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite meaningful advances in systemic therapy, the prognosis of patients with unresectable advanced or metastatic gastric cancer remains poor. Targeted and immunotherapeutic approaches benefit only selected subpopulations, while the majority of patients continue to lack effective treatment options. Claudin 18.2 (CLDN18.2) has recently emerged as a promising therapeutic target, and the CLDN18.2-targeted monoclonal antibody zolbetuximab has demonstrated clinically meaningful efficacy in multiple international clinical trials. However, evidence for its use in patients with severe renal impairment requiring maintenance hemodialysis is lacking. In this population, conventional chemotherapy is often limited by altered pharmacokinetics and the risk of heightened toxicity, highlighting an important unmet clinical need.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We report the case of a 46-year-old woman with metastatic CLDN18.2-positive, HER2-negative gastric adenocarcinoma who subsequently developed end-stage renal disease (ESRD) secondary to tumor progression, necessitating regular hemodialysis. Following multidisciplinary evaluation, irinotecan combined with zolbetuximab was initiated on the basis of individualized adjustment of the hemodialysis schedule. The regimen was well tolerated, associated with stabilization of renal function, and resulted in a marked decline in serum CA19\u20139 accompanied by a significant shrinkage of peritoneal metastatic lesions on CT imaging, with sustained disease control during treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights that in patients with advanced gastric cancer undergoing hemodialysis, CLDN18.2-targeted therapy combined with chemotherapy may be feasible and safe with close laboratory monitoring and individualized dialysis management and may serve as a valuable reference for personalized treatment in gastric cancer complicated by renal failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1798282","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T04:29:55Z","timestamp":1778560195000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Zolbetuximab combined with chemotherapy in a patient with CLDN18.2-positive advanced gastric cancer undergoing hemodialysis: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Yuhan","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]},{"name":"Zhejiang Provincial Clinical Research Center for Cancer","place":["Hangzhou, China"]},{"name":"Cancer Center of Zhejiang University","place":["Hangzhou, China"]},{"name":"Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuqi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]},{"name":"Zhejiang Provincial Clinical Research Center for Cancer","place":["Hangzhou, China"]},{"name":"Cancer Center of Zhejiang University","place":["Hangzhou, China"]},{"name":"Center for Medical Research and Innovation in Digestive System Tumors, Ministry of Education","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linglin","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Second Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Difei","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Second Affiliated Hospital of Zhejiang University School of Medicine","place":["Hangzhou, China"]},{"name":"Research Center for Clinical Pharmacy, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zitao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Hangzhou Normal University, Hangzhou","place":["Zhejiang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, Zhejiang, China"]},{"name":"Zhejiang Provincial Clinical Research 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