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World J Gastrointest Oncol. Aug 15, 2026; 18(8): 121158
Published online Aug 15, 2026. doi: 10.4251/wjgo.v18.i8.121158
Published online Aug 15, 2026. doi: 10.4251/wjgo.v18.i8.121158
Association of claudin 18.2 expression with outcomes of ramucirumab plus paclitaxel as second-line therapy in advanced gastric cancer
Mi-Ran Han, Division of Hematology-Oncology, Department of Internal Medicine, Jeonbuk National University Medical School and Hospital, Jeonju 54907, South Korea
Mi-Ran Han, Ji Eun Shin, Sung Hee Lim, Jeeyun Lee, Seung Tae Kim, Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
Author contributions: Han MR designed the study and wrote the manuscript; Han MR and Shin JE performed the research; Han MR and Lim SH analyzed the data; Lee J and Kim ST supervised the study and contributed to data interpretation; Kim ST revised the manuscript critically for important intellectual content; all authors have read and approved the final manuscript.
AI contribution statement: AI tools, specifically ChatGPT, were used only for limited language refinement and assistance with formal and polite academic English expression during preparation of the response to reviewers. AI tools were not used for manuscript writing, scientific interpretation, data analysis, statistical calculations, figure generation, or study design. All statistical analyses and figures were independently performed and generated by the authors using R software. No scientific content, results, or conclusions were generated by AI.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Samsung Medical Center (No. 2026-01-003).
Informed consent statement: The requirement for informed consent was waived by the Institutional Review Board of Samsung Medical Center due to the retrospective nature of the study.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Seung Tae Kim, PhD, Professor, Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-Gu, Seoul 06351, South Korea. shty1@skku.edu
Received: March 18, 2026
Revised: April 20, 2026
Accepted: May 13, 2026
Published online: August 15, 2026
Processing time: 142 Days and 22.9 Hours
Revised: April 20, 2026
Accepted: May 13, 2026
Published online: August 15, 2026
Processing time: 142 Days and 22.9 Hours
Core Tip
Core Tip: Claudin expression is an established biomarker for targeted therapy in gastric cancer; however, its clinical relevance remains uncertain. In this retrospective study, claudin expression was not associated with survival or treatment response in patients with advanced gastric cancer who were treated with ramucirumab plus paclitaxel. These findings highlight a key distinction between intrinsic tumor biomarkers and therapies targeting the tumor microenvironment. Claudin expression should not be used to guide second-line anti-angiogenic treatments, emphasizing the need for mechanism-based biomarker selection in precision oncology.