TPW 6.01 Claudin-18.2 in Pancreatic Ductal Adenocarcinoma: A Meta-analytic Review of Tumour-Specific Expression and Therapeutic Implications

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ID: 324002
2026
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Abstract
Abstract Aims To assess the prevalence, tumour-specific, and clinicopathological associations of CLDN18.2 expression in pancreatic ductal adenocarcinoma (PDAC), and to identify sources of heterogeneity to clarify its value as a therapeutic target. Methods A systematic search of six databases was conducted from inception to August 2025 as per PRISMA guidelines. Included studies evaluated CLDN18.2 expression in PDAC using immunohistochemistry with defined positivity thresholds. Random-effects meta-analyses estimated pooled prevalence, odds ratios (ORs), and heterogeneity (I²), with subgroup analyses by antibody clone and geographic region. Results Sixteen studies including 2,025 patients with PDAC were included. The pooled prevalence of CLDN18.2 expression was 51.60% (95% CI: 40.93–62.19), with substantial heterogeneity (I² = 95.4%). Expression varied significantly by antibody clone, from 23.27% (43–14A) to 77.63% (HPA-018446) (p = 0.0006). No statistically significant differences were observed across geographic regions. CLDN18.2 expression was highly specific to neoplastic tissue (OR = 102.40; 95% CI: 35.50–295.38). No significant associations were identified with sex, tumour location, T-stage, N-stage, or M-stage. However, expression was significantly lower in poorly differentiated tumours (G3 vs. G1/G2: OR = 0.37; 95% CI: 0.20–0.70). Conclusion CLDN18.2 is frequently expressed in PDAC and is highly tumour-specific, supporting its therapeutic relevance. Its reduced expression in poorly differentiated tumours may reflect potential prognostic significance. The significant variation in prevalence across antibody clones underscores the urgent need for assay standardization. These findings support the further investigation of CLDN18.2 as a clinically actionable biomarker and therapeutic target in PDAC, particularly in the context of emerging CLDN18.2-directed therapies.
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Authors Mohammed Al Subhi, Deema Al-Nabhani, Maryam Al-Sarmi, Ahmed Abd Elrahman, Yaqoob Al-Sawafi, Younis Al-Mufargi
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.354
URL
https://doi.org/10.1093/bjs/znag087.354
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