How to master the correct usage and dosage of zotuximab/veluoyin

Zolbetuximab (zolbetuximab)-Vyloy is the first approved CLDN18.2-targeting monoclonal antibody. Its usage and dosage are highly professional and are often used in combination with fluoropyrimidine- and platinum-based chemotherapy regimens. Correctly mastering the administration method and timing is an important link that affects efficacy, safety and tolerability. In clinical use, Vyloy is mainly administered through intravenous infusion, and the dose is determined based on body surface area. This is a commonly used monoclonal antibody administration method in international cancer treatment.

In the common recommended regimen, the first infusion dose is 800 mg/m², and then enters the maintenance treatment phase. You can choose to continue treatment at a rhythm of 600 mg/m² every three weeks or 400 mg/m² every two weeks. Different cycle arrangements are mainly selected based on the hospital's usual chemotherapy regimen and patient tolerance. Doctors will develop an individualized plan based on tumor burden, previous treatment experience, and control of gastrointestinal symptoms. Since zotuximab is a targeted antibody, its infusion speed, pretreatment medication, and observation time all need to follow strict procedures to reduce risks such as infusion reactions.

It is particularly important to emphasize that if zotuximab is administered on the same day as fluoropyrimidine- and platinum-containing chemotherapy, zotuximab must be infused first, which is a clear operational requirement in the official dosing guidelines. The reason is that antibody drugs usually need to be infused in a stable environment, and chemotherapy drugs may increase the risk of adverse reactions. Therefore, giving zotuximab first will help control the monitoring window for infusion reactions. Overseas oncology institutions generally follow this sequence to ensure consistency in the medication process.

Infusion reactions are the most frequently highlighted risk factor during the use of targeted antibodies. While serious reactions are uncommon, the first infusion often requires longer monitoring, which is why the first dose is usually higher and administered in a professional medical setting. The doctor will adjust the observation duration based on the patient's weight, liver and kidney function, and previous chemotherapy tolerance. If necessary, pretreatment with antihistamines or steroids will be given to improve safety.

Reference materials:https://www.astellas.com/en/news/29401