Arcotatug Tavatecan Offers Manageable Safety in Advanced Gastric Cancer

In an interview at the 2026 ESMO Congress, Kohei Shitara, MD, director of gastrointestinal oncology at the National Cancer Center Hospital East in Kashiwa, Japan, discusses safety and tolerability findings from the phase 3 G-HOPE-001 study (NCT06238843), which evaluated arcotatug tavatecan (IBI343), a CLDN18.2-targeted antibody-drug conjugate (ADC), vs chemotherapy in patients with previously treated, CLDN18.2-positive advanced gastric or gastroesophageal junction adenocarcinoma.

Despite a longer median treatment duration with arcotatug tavatecan compared with chemotherapy (5 vs 2 months), the incidence of grade 3 or higher treatment-related adverse events was lower with the ADC (47% vs 56%). Only 18% of patients required dose reductions, and fewer than 2% permanently discontinued treatment. Shitara also highlights lower rates of hematologic toxicities, including neutropenia and leukopenia, with arcotatug tavatecan.

Gastrointestinal toxicities, an important consideration with CLDN18.2-targeted agents, were also comparable or less frequent with arcotatug tavatecan than with chemotherapy. Shitara discusses how the overall safety profile, including the ability of most patients to maintain their treatment dose, supports arcotatug tavatecan as a manageable treatment option in later-line CLDN18.2-positive advanced gastric cancer.