Claudin 18.2 Directed Therapies- Target Population, Competitive Landscape, and Market Forecast - 2034

Key Highlights:

• Claudin 18.2, a tight-junction molecule predominantly found in the nonmalignant gastric epithelium, becomes accessible on the tumor cell surface during malignant transformation, thereby providing an appealing target for cancer therapy.
• Claudin 18.2-directed therapies are active in multiple indications, including gastric cancer, pancreatic cancer, gastroesophageal junction adenocarcinoma, and other solid tumors.
• Astellas' VYLOY (zolbetuximab) is the first and only approved Claudin 18.2 directed therapy for the treatment of advanced gastric and gastroesophageal junction adenocarcinoma. It received regulatory approval in Japan in March 2024, followed by approval in the UK in August 2024 and the US FDA approved the therapy in October 2024.
• Claudin 18.2 directed therapies have a robust pipeline, with candidates such as ASKB589, IBI-343, AZD0901, ATG022, SKB315, Spevatamig (PT886) in late-Phase (II/III) trials targeting diverse indications like advanced gastric, gastroesophageal junction and other solid tumors.
• In January 2025, Antennova presented the latest Phase I/II data on ATN-022 in advanced/metastatic gastric cancer, showing an ORR of 42.9%, at ASCO GI 2025.
• In May 2025, Astellas entered an exclusive license agreement with Evopoint Biosciences for XNW27011, a novel clinical-stage antibody-drug conjugate targeting CLDN18.2.
• Several companies including AskGene, Innovent, Antegene, Kelun, AstraZeneca, Phanes, and others are currently engaged in the development and production of CLDN 18.2 therapies, which have the potential to significantly impact and enhance the MCR therapies market.

DelveInsight's "Claudin 18.2 directed therapies- Target Population, Competitive Landscape, and Market Forecast - 2034" report delivers an in-depth understanding of the Claudin 18.2, historical and Competitive Landscape as well as the Claudin 18.2 directed therapies market trends in the United States, EU4 (Germany, France, Italy, and Spain) and the United Kingdom, and Japan.

The Claudin 18.2 directed therapies market report provides current treatment practices, emerging drugs, market share of individual therapies, and current and forecasted 7MM Claudin 18.2 directed therapies market size from 2020 to 2034. The report also covers current Claudin 18.2 directed therapies treatment practices/algorithms and unmet medical needs to curate the best opportunities and assess the market's potential.

Geography Covered:

• The United States
• EU4 (Germany, France, Italy, and Spain) and the United Kingdom
• Japan

Study Period: 2020-2034

Claudin 18.2 Directed Therapies Disease Understanding and Treatment Algorithm

Claudin 18.2 Directed Therapies Overview

Claudin 18.2 is a tight junction protein that plays a key role in maintaining the integrity of the gastric epithelium. It is one of two isoforms of the CLDN18 gene, with Claudin 18.2 being specifically and normally expressed only in differentiated epithelial cells of the gastric mucosa. In healthy tissue, it is buried within tight junctions, making it inaccessible to therapeutic agents. However, during malignant transformation in cancers such as gastric, gastroesophageal junction (GEJ), and pancreatic cancers, CLDN18.2 becomes aberrantly exposed on the tumor cell surface while retaining restricted expression in healthy tissues.

This unique expression pattern makes CLDN18.2 an attractive and highly selective therapeutic target. The most advanced therapy is VYLOY, a monoclonal antibody that binds to CLDN18.2, triggering immune-mediated tumor cell destruction. VYLOY has shown promising results in late-stage clinical trials and has been approved for CLDN18.2-positive gastric and GEJ cancers. Other investigational approaches include CAR-T cell therapies, bispecific antibodies, and antibody-drug conjugates.

Detection of CLDN18.2 expression by immunohistochemistry (IHC) helps identify eligible patients for targeted therapy, reinforcing its role as both a biomarker and a therapeutic target in precision oncology.

Claudin 18.2 Directed Therapies Epidemiology

The Claudin 18.2 directed therapies epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented as total cases of selected indication for Claudin 18.2 directed therapies, total eligible patients of selected indication, total treated cases in selected indication for Claudin 18.2 directed therapies in the 7MM covering the United States, EU4 (Germany, France, Italy, and Spain), and the United Kingdom, and Japan from 2020 to 2034.

• The total incident cases of gastric cancer including GEJ in the US comprised around 29,500 cases in 2024.
• Among EU4 and the UK, the highest number of incident cases of gastric cancer including GEJ was found in Germany.
• In 2024, the estimated incidence of pancreatic cancer in Japan was approximately 47,500 cases.
• Gastric cancer including GEJ is more prominent in males (66%) than in females (33%).
• Gastric cancer including GEJ stage IV had the highest number of cases in 2024 in the US, whereas in Japan stage I had more cases.
• The total incident cases of Pancreatic adenocarcinoma cases in the US in 2024 was approximately 56,500.

Claudin 18.2 Directed Therapies Drug Chapters

The drug chapter segment of the Claudin 18.2 directed therapies reports encloses a detailed analysis of marketed drugs and late-stage (Phase III and Phase II) pipeline drugs. It also helps to understand the Claudin 18.2 directed therapies clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details, advantages and disadvantages of each included drug, and the latest news and press releases.

Marketed Drugs

VYLOY (zolbetuximab): Astellas

VYLOY is a cytolytic antibody that specifically targets claudin 18.2 and is approved for use in combination with fluoropyrimidine- and platinum-based chemotherapy as a first-line treatment for adults with locally advanced, unresectable, or metastatic HER2-negative gastric or gastroesophageal junction adenocarcinoma. This treatment is intended for patients whose tumors test positive for claudin 18.2, as determined by an FDA-approved diagnostic assay.

As a claudin 18.2-directed cytolytic antibody, VYLOY eliminates CLDN18.2-expressing cells via antibody-dependent cellular cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC). Preclinical studies demonstrated that combining VYLOY with chemotherapy produces enhanced antitumor effects in CLDN18.2-positive tumors compared to either agent used alone.

Emerging Drugs

ASKB589: AskGene

ASKB589 is a humanized IgG1 monoclonal antibody targeting CLDN1 engineered with enhanced antibody-dependent cellular cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC).

ASKB589 plus CAPOX and PD-1 inhibitor as a first-line treatment in patients with G/GEJ cancer demonstrated good safety and tolerability. Adding a PD-1 inhibitor to ASKB589 plus CAPOX in patients with moderate to high CLDN18.2 expression resulted in encouraging anti-tumor activities with deep and durable responses.

IBI-343: Innovent

IBI-343 is a recombinant human monoclonal antibody directed against Claudin 18.2, conjugated to topoisomerase I inhibitor payload (Exatecan). Designed with an Fc-silenced backbone to minimize off-target immune activation, it utilizes a cleavable linker that facilitates targeted intracellular drug release and enables a bystander effect, killing adjacent tumor cells with low antigen expression. The drug has received Fast Track Designation from the U.S. FDA and is currently being evaluated in the Phase III G-HOPE trial (NCT06238843).

Claudin 18.2 Directed Therapies Market Outlook

Claudin 18.2 has swiftly gained prominence as a high-value therapeutic target in oncology, particularly for gastric and gastroesophageal junction adenocarcinomas. This momentum stems from its distinct expression profile-highly prevalent in malignant epithelial tissues while showing limited presence in normal tissues-making it exceptionally well-suited for tumor-specific interventions.

A significant inflection point came with the approval of VYLOY (zolbetuximab) by Astellas, first in Japan (March 2024) and subsequently in the United States (October 2024). As the first and only approved monoclonal antibody targeting Claudin 18.2, VYLOY has established a strong foothold in the treatment of advanced gastric and GEJ cancers. Its demonstrated efficacy, particularly in combination with chemotherapy, and its first-mover advantage position it as the current standard of care within this niche.

However, the Claudin 18.2 directed therapies therapeutic landscape is evolving rapidly, marked by a robust pipeline of late-stage contenders. Key Phase III candidates such as AZD0901 (AstraZeneca), ASKB589 (AskGene), and IBI-343 (Innovent) are poised to directly challenge VYLOY's market dominance, particularly in Asia, where clinical development is progressing at an accelerated pace. Additionally, emerging candidates like ATG-022 (Antegene) and SKB315 (Kelun)-both in earlier stages of development-signal a diversification of indications beyond gastric/GEJ cancers, including broader solid tumor applications.

A notable innovation in the pipeline is Spevatamig (PT886), a bispecific antibody from Phanes therapeutics that targets both Claudin 18.2 and CD47. Currently, in Phase II trials, Spevatamig is being evaluated for gastric/GEJ cancers as well as pancreatic ductal adenocarcinoma (PDAC), reflecting a broader strategic pivot toward immune-modulatory and combination-based approaches. This shift encompasses monotherapies, bispecific constructs, and combinations with chemotherapy or checkpoint inhibitors, all aiming to enhance clinical outcomes and address treatment resistance.

The therapeutic appeal of Claudin 18.2 directed therapies lies in its high tumor specificity, which enables reduced off-target toxicity and potentially improved safety profiles compared to traditional chemotherapy or generalized immunotherapy. Its expression is most validated in gastric and GEJ cancers, but has also been observed in pancreatic, lung, and ovarian tumors. This broadens its potential in precision oncology, though clinical validation in non-gastric indications is still emerging.

As the field matures, the integration of biomarker-driven diagnostics will be critical for patient selection, enabling more effective treatment stratification and improved clinical outcomes. The growing adoption of Claudin 18.2 directed therapies testing will likely parallel the rise in targeted therapy utilization.

Looking ahead, while VYLOY is expected to retain market leadership through at least 2026, the competitive landscape is intensifying. Advanced-stage programs such as AZD0901, ASKB589, and IBI-343 are well-positioned to capture a significant share, particularly in regions with rapid clinical and regulatory progress. Meanwhile, novel constructs like Spevatamig may redefine the therapeutic paradigm by coupling tumor targeting with immune engagement.

In summary, Claudin 18.2 directed therapies are on track to become foundational in the treatment of gastrointestinal and select solid tumors. Fueled by innovation in antibody engineering, combination strategies, and biomarker testing, this therapeutic class is set to play a transformative role in the next generation of precision oncology.

Claudin 18.2 Directed Therapies Drugs Uptake

This section focuses on the uptake rate of potential drugs expected to be launched in the market during 2025-2034, which depends on the competitive landscape, safety, and efficacy data, along with the order of entry. It is important to understand that the key players evaluating their novel therapies in the pivotal and confirmatory trials should remain vigilant when selecting appropriate comparators to stand the greatest chance of a positive opinion from regulatory bodies, leading to approval, smooth launch, and rapid uptake.

Claudin 18.2 Directed Therapies Pipeline Development Activities

The report provides insights into different therapeutic candidates in Phase III, Phase II, and Phase I. It also analyzes key players involved in developing targeted therapeutics.

The presence of numerous drugs at different stages is expected to generate immense opportunities for the Claudin 18.2 directed therapies market growth over the forecasted period.

Pipeline Development Activities

The report covers information on collaborations, acquisitions and mergers, licensing, and patent details for Claudin 18.2 directed therapies.

KOL Views

To keep up with current and future market trends, we take Industry Experts' opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry experts were contacted for insights on Claudin 18.2 directed therapies' evolving treatment landscape, patient reliance on conventional therapies, patient therapy switching acceptability, drug uptake, along challenges related to accessibility.

DelveInsight's analysts connected with 20+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. Centers such as the MD Anderson Cancer Center, Massachusetts General Hospital Cancer Center, National Cancer Center Hospital East, Sorbonne University, University Medical Center Mainz, University of Cambridge, and others.

Their opinion helps understand and validate current and emerging therapy treatment patterns or Claudin 18.2 directed therapies market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.

Qualitative Analysis

We perform Qualitative and market Intelligence analysis using various approaches, such as SWOT analysis and Conjoint Analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of gaps in disease diagnosis, patient awareness, physician acceptability, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided.

Conjoint Analysis analyzes multiple approved and emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy. In efficacy, the trial's primary and secondary outcome measures are evaluated; for instance, in event-free survival, one of the most important primary outcome measures is event-free survival and overall survival.

Further, the therapies' safety is evaluated, wherein the acceptability, tolerability, and adverse events are majorly observed, and it sets a clear understanding of the side effects posed by the drug in the trials. In addition, the scoring is also based on the probability of success and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.

Market Access and Reimbursement

Reimbursement may be referred to as the negotiation of a price between a manufacturer and a payer that allows the manufacturer access to the market. It is provided to reduce the high costs and make the essential drugs affordable. Health technology assessment (HTA) plays an important role in reimbursement decision-making and recommending the use of a drug. These recommendations vary widely throughout the seven major markets, even for the same drug.

In the US healthcare system, both Public and Private health insurance coverage are included. Also, Medicare and Medicaid are the largest government-funded programs in the US. The major healthcare programs, including Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the state and federal health insurance marketplaces, are overseen by the Centers for Medicare & Medicaid Services (CMS). Other than these, Pharmacy Benefit Managers (PBMs) and third-party organizations that provide services and educational programs to aid patients are also present.

The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.

Key Updates on Claudin 18.2 Directed Therapies

• In June 2025, Innovent updated the Phase I study results of IBI343, a novel anti-CLDN18.2 ADC, for the treatment of advanced pancreatic cancer at the 2025 ASCO Annual Meeting.
• In July 2024, Astellas received a positive CHMP opinion for zolbetuximab in combination with chemotherapy for the treatment of advanced gastric and gastroesophageal junction cancer.
• In March 2024, the FDA granted a Fast Track Designation to PT886, a first-in-class native IgG-like bispecific antibody, for metastatic CLDN18.2-positive pancreatic adenocarcinoma treatment.
• In January 2024, AskGene Pharma presented encouraging clinical results for ASKB589, an anti-CLDN18.2 antibody, at the ASCO-GI 2024 in San Francisco.
• In May 2023, The FDA granted two orphan drug designations to ATG-022 for the treatment of gastric cancer and pancreatic cancer.

The abstract list is not exhaustive and will be provided in the final report.

Scope of the Report:

• The report covers a segment of key events, an executive summary, and a descriptive overview of Claudin 18.2, explaining its mechanism and therapies (current and emerging).
• Comprehensive insight into the Competitive Landscape, and forecasts, the future growth potential of treatment rate, drug uptake, and drug information have been provided.
• Additionally, an all-inclusive account of the current and emerging therapies and the elaborate profiles of late-stage and prominent therapies will impact the current landscape.
• A detailed review of the Claudin 18.2 directed therapies market, historical and forecasted market size, market share by therapies, detailed assumptions, and rationale behind our approach is included in the report, covering the 7MM drug outreach.
• The report provides an edge while developing business strategies, by understanding trends, through SWOT analysis, expert insights/KOL views, and treatment preferences that help shape and drive the 7MM Claudin 18.2 directed therapies market.

Claudin 18.2 Directed Therapies Report Insights

• Claudin 18.2 Targeted Patient Pool
• Therapeutic Approaches
• Claudin 18.2 directed therapies Pipeline Analysis
• Claudin 18.2 directed therapies Market Size and Trends
• Existing and future Market Opportunity

Claudin 18.2 Directed Therapies Report Key Strengths

• Ten-Year Forecast
• The 7MM Coverage
• Key Cross Competition
• Drug Uptake and Key Market Forecast Assumptions

Claudin 18.2 Directed Therapies Report Assessment

• Current Treatment Practices
• Unmet Needs
• Pipeline Product Profiles
• Market Attractiveness
• Qualitative Analysis (SWOT and Conjoint Analysis)

Key Questions:

• What was the Claudin 18.2 directed therapies total market size, the market size by therapies, market share (%) distribution, and what would it look like in 2034? What are the contributing factors for this growth?
• Which drug is going to be the largest contributor in 2034?
• What are the pricing variations among different geographies for approved therapies?
• How the reimbursement landscape has for Claudin 18.2 directed therapies evolved since the first one was approved? Do patients have any access issues that are driven by reimbursement decisions?
• What are the risks, burdens, and unmet needs of treatment with Claudin 18.2 directed therapies? What will be the growth opportunities across the 7MM for the patient population of Claudin 18.2 directed therapies?
• What are the key factors hampering the growth of the Claudin 18.2 directed therapies market?
• What are the indications for which recent novel therapies and technologies have been developed to overcome the limitations of existing treatments?
• What key designations have been granted to the therapies for Claudin 18.2s?
• What is the cost burden of approved therapies on the patient?
• Patient acceptability in terms of preferred therapy options as per real-world scenarios?
• What are the country-specific accessibility issues of expensive, recently approved therapies?
• Reasons to buy
• The report will help develop business strategies by understanding the latest trends and changing dynamics driving the Claudin 18.2 directed therapies Market.
• Understand the existing market opportunities in varying geographies and the growth potential over the coming years.
• Distribution of historical and current patient share based on real-world prescription data along with reported sales of approved products in the US, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.
• Identifying strong upcoming players in the market will help devise strategies to help get ahead of competitors.
• Detailed analysis and ranking of indication-wise current and emerging therapies under the conjoint analysis section to provide visibility around leading indications.
• Highlights of Access and Reimbursement policies of approved therapies, barriers to accessibility of expensive off-label therapies, and patient assistance programs.
• To understand Key Opinion Leaders' perspectives around the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in the future.
• Detailed insights on the unmet needs of the existing market so that the upcoming players can strengthen their development and launch strategy.