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항목
AntibodyCurated CoreFDAstaleApproved
zolbetuximab (Vyloy, IMAB362, zolbetuximab-clzb, claudiximab)
Astellas·CLDN18.2 (claudin-18.2)
26 trials
AntibodyCurated CoreFDAstaleApproved
zanidatamab (Ziihera, ZW25, zanidatamab-hrii)
Jazz Pharmaceuticals / Zymeworks·HER2 (biparatopic)
35 trials
ADCCurated CoreFDAstaleApproved
trastuzumab deruxtecan (Enhertu, T-DXd, DS-8201, TDxd)
Daiichi Sankyo / AstraZeneca·HER2
243 trials
Overview
Program
Vyloy (zolbetuximab)Ziihera (zanidatamab)Enhertu (fam-trastuzumab deruxtecan-nxki)
Overview
Company
AstellasJazz Pharmaceuticals / ZymeworksDaiichi Sankyo / AstraZeneca
Overview
Modality
ANTIBODYANTIBODYADC
Overview
Target
CLDN18.2 (claudin-18.2)HER2 (biparatopic)HER2
Overview
Indication
CLDN18.2-positive HER2-negative advanced gastric or gastroesophageal junction adenocarcinomaFirst-line HER2-positive gastric, GEJ, or esophageal adenocarcinoma; previously treated HER2-positive biliary tract cancerHER2-positive breast cancer (including regimen-specific first-line and early-stage indications); HER2-low/ultralow breast cancer, HER2-positive gastric cancer, HER2-mutant NSCLC and HER2-positive solid tumors: consult the current US label
Overview
Phase
APPROVEDAPPROVEDAPPROVED
Overview
Status
APPROVEDAPPROVEDAPPROVED
Overview
Content status
Curated CoreCurated CoreCurated Core
Overview
Data Confidence
Editorial scope · Curated CoreEditorial scope · Curated CoreEditorial scope · Curated Core
Overview
Development Signal
Development Signal · EstablishedDevelopment Signal · EstablishedDevelopment Signal · Established
Overview
Approval status
FDA approvedFDA approvedFDA approved
Positioning
Key differentiator
Exploits a tight-junction protein that only becomes accessible after malignant transformation, creating tumor selectivity without a novel modality.Dual-epitope binding drives receptor clustering, faster internalization, and stronger signaling blockade than either monoclonal alone. In GEA the label splits IHC 3+ (chemo doublet) from IHC 3+ or 2+/ISH+ (chemo + Tevimbra).High DAR (~8), bystander effect, HER2-low activity
Positioning
Known limitation
CLDN18.2 heterogeneity and loss under treatment pressure.HER2 heterogeneity, PI3K pathway activation, and bypass RTK signaling.HER2 antigen loss/downregulation, payload efflux, and dose-limiting ILD/pneumonitis leading to discontinuation.
Positioning
Development positioning
1L with fluoropyrimidine and platinum chemotherapy1L GEA with fluoropyrimidine-platinum ± Tevimbra; 2L+ BTC monotherapyIndication- and regimen-specific; includes 1L + pertuzumab in HER2-positive metastatic breast cancer
Technology
Payload
——DXd (topo-I inhibitor)
Technology
Linker
——Cleavable tetrapeptide
MoA
Mechanism
Binds CLDN18.2 on gastric tumor cells and kills them through antibody-dependent cellular cytotoxicity and complement-dependent cytotoxicity.Simultaneous binding of two non-overlapping HER2 epitopes crosslinks adjacent receptors, causing receptor clustering, internalization, and degradation alongside ADCC and complement activity.Fam-trastuzumab deruxtecan is a HER2-directed antibody-drug conjugate: humanized anti-HER2 IgG1 linked via a cleavable tetrapeptide linker to DXd, a membrane-permeable topoisomerase I inhibitor. After binding HER2 on tumor cells, the conjugate is internalized; lysosomal proteases cleave the linker and release DXd, causing DNA damage and apoptosis. Released DXd can exert a bystander effect in neighboring cells.
MoA
Biomarker
CLDN18.2 IHC with ≥75% of tumor cells at moderate-to-strong membranous staining.GEA: PATHWAY 4B5 IHC and VENTANA Dual ISH. IHC 3+ for chemo doublet; IHC 3+ or IHC 2+/ISH+ when Tevimbra is added. BTC: HER2 IHC 3+.HER2 expression (IHC/ISH per indication); higher systemic exposure associated with greater ILD incidence (FDA label §12.2).
Toxicology
Species
——Cynomolgus monkey, NHP, Rat, Hamster
Toxicology
Animal (cat.)
——NHP
Toxicology
Major finding
Nausea and vomiting are frequent and often infusion-related, requiring rate adjustment and antiemetics. Hypoalbuminemia, appetite loss, and hypersensitivity also occur.Embryo-fetal toxicity warning. Diarrhea, infusion-related reactions, and left ventricular dysfunction require monitoring, as with the HER2 antibody class.ILD-like lung findings at high exposure
Toxicology
CRS
N/AN/AMinimal
Toxicology
NOAEL
——10 mg/kg
Clinical
Safety signal
Nausea and vomiting are frequent and often infusion-related, requiring rate adjustment and antiemetics. Hypoalbuminemia, appetite loss, and hypersensitivity also occur.Embryo-fetal toxicity warning. Diarrhea, infusion-related reactions, and left ventricular dysfunction require monitoring, as with the HER2 antibody class.ILD-like lung findings at high exposure
Clinical
Selected reported efficacy
——ORR 87%
Clinical
Reported ORR
——87% vs 81% (THP)
Clinical
Reported PFS
——40.7 months vs 26.9 months (THP)
Clinical
Reported OS
——Immature at the reported PFS analysis
Clinical
Result source
——FDA label 2026, Table 28 — DESTINY-Breast09 (NCT04784715)
Clinical
Program phase
APPROVEDAPPROVEDAPPROVED
Clinical
Trial activity
No active/completed countsNo active/completed countsNo active/completed counts
Clinical
Trial ref
——NCT04784715
Preclinical
Animal (cat.)
——Human, Mouse, In vitro