What are the recommended pre‑medication, monitoring, and management steps for infusion‑related reactions to zolbetuximab (anti‑CLDN18.2 monoclonal antibody) in patients with advanced gastric or gastro‑esophageal adenocarcinoma?

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Last updated: February 25, 2026View editorial policy

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Management of Zolbetuximab Infusion-Related Reactions

Zolbetuximab infusion-related reactions, particularly nausea and vomiting, occur in over 75% of patients and are most severe during the first infusion cycle, requiring mandatory prophylactic high-risk antiemetic protocols with NK-1 antagonists, 5-HT3 antagonists, and corticosteroids, combined with careful infusion rate control using a stop-and-go strategy. 1

Pre-Medication Protocol

Mandatory antiemetic prophylaxis must follow high-risk protocols:

  • Administer NK-1 receptor antagonists (aprepitant or fosaprepitant) before each infusion 1
  • Combine with 5-HT3 receptor antagonists (ondansetron, granisetron, or palonosetron) 1
  • Add corticosteroids (dexamethasone) as part of the triple antiemetic regimen 1
  • This prophylactic approach is critical because nausea and vomiting represent the most common adverse events with >10% difference compared to chemotherapy alone 2

Infusion Rate Management

The first cycle carries the highest risk and requires meticulous attention:

  • The loading dose (800 mg/m²) combined with faster infusion rates during cycle 1 significantly increases infusion-related reaction risk 1
  • Implement a "stop-and-go" strategy: pause the infusion immediately if symptoms develop, then resume at a slower rate once symptoms resolve 1
  • Subsequent cycles use maintenance dosing (600 mg/m² every 3 weeks), which is associated with lower reaction rates 3, 4

Monitoring During Infusion

Active surveillance throughout the infusion is essential:

  • Monitor continuously for gastrointestinal symptoms (nausea, vomiting) which are predominantly grade 1-2 but can progress 4
  • Watch for signs of infusion-related reactions during the first cycle when risk is highest 1
  • Exposure-response analysis demonstrates that higher zolbetuximab exposures increase the probability of gastrointestinal events and infusion-related reactions 3

Management of Active Reactions

When infusion reactions occur:

  • Immediately pause the infusion using the stop-and-go approach 1
  • Administer additional antiemetics as needed for breakthrough symptoms 1
  • Once symptoms are controlled, resume infusion at a reduced rate 1
  • Most adverse events are manageable and do not require treatment discontinuation 4

Risk Stratification

The severity profile follows a predictable pattern:

  • First infusion: highest risk due to loading dose and faster infusion rate 1
  • Subsequent infusions: lower risk with maintenance dosing 3
  • Grade ≥3 adverse events show no substantial increases overall compared to chemotherapy alone, though nausea and vomiting remain the most frequent grade 3+ events 2, 4

Common Pitfalls to Avoid

Critical errors that compromise patient safety:

  • Inadequate prophylaxis: Failing to use the complete triple antiemetic regimen (NK-1 + 5-HT3 + corticosteroid) before the first infusion 1
  • Ignoring infusion rate: Administering the loading dose too rapidly without readiness to implement stop-and-go protocols 1
  • Insufficient first-cycle monitoring: Not recognizing that cycle 1 requires heightened vigilance compared to subsequent cycles 1
  • Premature discontinuation: Stopping therapy for manageable grade 1-2 gastrointestinal symptoms that can be controlled with proper antiemetic optimization 4, 1

Additional Safety Considerations

Other adverse events requiring monitoring:

  • Anemia and neutropenia (grade ≥3) were observed in clinical trials, though these are often attributable to concurrent chemotherapy 2
  • Decreased appetite was noted as a grade ≥3 adverse event in the SPOTLIGHT trial 2
  • Antidrug antibody incidence is low with no apparent clinical consequences 3

Pharmacokinetic Factors

Understanding exposure relationships:

  • Zolbetuximab follows two-compartment pharmacokinetics with linear and time-dependent clearance 3
  • Gastrectomy increases trough concentrations by ≥50%, but this does not alter the benefit-risk profile or require dose adjustment 3
  • No dose adjustments are necessary for mild/moderate renal impairment or mild hepatic impairment 3

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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