What are the rates of nausea/vomiting by cycle with zolbetuximab?

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In SPOTLIGHT and GLOW, the incidence of nausea/vomiting was most frequent in Cycle 1 with zolbetuximab + mFOLFOX6/CAPOX and decreased in later cycles

In the combined SPOTLIGHT and GLOW analysis, nausea and/or vomiting were most common on the first infusion day of zolbetuximab and generally decreased on infusion Days 2 to 4.¹

During the first zolbetuximab infusion day, 46.5% (246/529) of patients experienced nausea and 41.0% (217/529) experienced vomiting.
During the second zolbetuximab infusion day, 23.2% (97/418) of patients experienced nausea and 24.4% (102/418) experienced vomiting.

Figure 1. All occurrence of nausea or vomiting in SPOTLIGHT²

Zolbetuximab or placebo with mFOLFOX6 were administered in 42-day cycles.

^aThe onset day in the onset interval was defined as the date of onset minus the date of first dose plus 1.

Abbreviations: mFOLFOX6: modified leucovorin calcium (folinic acid), fluorouracil, and oxaliplatin.

Adapted from: Supplement to Shitara et al. Lancet. 2023.

Figure 2. All occurrence of nausea or vomiting in GLOW³

Zolbetuximab or placebo with CAPOX were administered in 21-day cycles.

^aThe onset day in the onset interval was defined as the date of onset minus the date of first dose plus 1.

Abbreviations: CAPOX: capecitabine and oxaliplatin.

Adapted from: Shah et al. Nat Med. 2023.

Figure 3. Occurrences of nausea or vomiting on the day of infusion for infusions 1 to 4 in patients who received zolbetuximab or placebo^a,¹

^aData represent the combined analysis of SPOTLIGHT and GLOW.

Adapted from: Shitara et al. ESMO Open 2026.

Shitara K, Smith E, Lordick F, et al. Impact and effective management of nausea/vomiting on patients treated with zolbetuximab + chemotherapy: insights from the phase III SPOTLIGHT and GLOW studies. ESMO Open. 2026;epub ahead of print105931. Available at: https://doi.org/10.1016/j.esmoop.2025.105931.
Shitara K, Lordick F, Bang YJ, et al. Supplement to: Zolbetuximab plus mFOLFOX6 in patients with CLDN18.2-positive, HER2-negative, untreated, locally advanced unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma (SPOTLIGHT): a multicentre, randomised, double-blind, phase 3 trial. Lancet. 2023;401(10389):1655-1668. Available at: https://doi.org/10.1016/s0140-6736(23)00620-7.
Shah MA, Shitara K, Ajani JA, et al. Zolbetuximab plus CAPOX in CLDN18.2-positive gastric or gastroesophageal junction adenocarcinoma: the randomized, phase 3 GLOW trial. Nat. Med. 2023;29(8):2133-2141. Available at: https://doi.org/10.1038/s41591-023-02465-7.