CASE REPORT article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1700562
A case of zolbetuximab-based chemotherapy for Claudin 18.2-positive gastric phenotype adenocarcinoma arising in Meckel's diverticulum
Provisionally accepted
- Faculty of Sustainable Design, University of Toyama, Gofuku, Japan
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A 74-year-old male presented with abdominal bloating and was diagnosed with unresectable advanced adenocarcinoma from Meckel's diverticulum with distant lung metastases and peritoneal dissemination. On immunohistochemical analysis, the tumor was positive for MUC5AC and MUC6 and negative for MUC2 and CDX2, indicating a gastric phenotype. Histological examination of the adjacent non-cancerous tissues confirmed the presence of ectopic gastric epithelium, resulting in a final diagnosis of adenocarcinoma arising from ectopic gastric tissue within Meckel's diverticulum. Biomarker profiling demonstrated Claudin18.2 positivity, HER2 negativity, and mismatch repair proficiency. Treatment was started with zolbetuximab plus FOLFOX, which is typically used for CLDN18.2-positive gastric cancer, resulting in a partial response. This is the first case of zolbetuximab-based therapy applied to adenocarcinoma from Meckel's diverticulum with a gastric phenotype due to a biomarker profile of gastric cancer. This case highlights the importance of identifying both the biomarker profile and tissue of origin of the tumor.
Keywords: zolbetuximab, Meckel's diverticulum, gastric cancer, case report, Claudin18.2 (CLDN18.2)
Received: 07 Sep 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Nagata. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kohei Nagata, nagatako59@gmail.com
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