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已发表论文
卡度尼利单抗联合化疗作为免疫治疗后二线治疗晚期 HER2 阴性胃癌或胃食管结合部癌的现实世界疗效
Authors Liu Z, Lu Y, Li M, Xiang J , Sun P, Liu A
Received 9 July 2025
Accepted for publication 16 October 2025
Published 25 October 2025 Volume 2025:19 Pages 9559—9569
DOI https://doi.org/10.2147/DDDT.S548735
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Anastasios Lymperopoulos
Zeyu Liu,* Yuxiao Lu,* Ming Li, Jinyu Xiang, Ping Sun, Aina Liu
Department of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ping Sun, Department of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, People’s Republic of China, Email sunping20039@hotmail.com Aina Liu, Department of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, People’s Republic of China, Email nana4312@sina.com
Background: Immunotherapy is now a cornerstone of first-line treatment for advanced gastric or gastroesophageal junction cancer (G/GEJC). However, optimal second-line options after progression on first-line immunotherapy are undefined. Given the established efficacy of cadonilimab in the first-line setting, this real-world study evaluated its combination with chemotherapy as a second-line treatment.
Methods: We conducted a single-center retrospective study of patients with advanced G/GEJC progressing after first-line immunotherapy. Patients received either cadonilimab plus chemotherapy (Cohort A, n=50) or chemotherapy alone (Cohort B, n=62) as second-line therapy between October 2022 and April 2025. The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and safety.
Results: Cohort A showed significantly improved outcomes. Median PFS was 4.9 months (95% CI: 3.9– 6.0) in Cohort A vs 3.8 months (95% CI: 2.8– 4.8) in Cohort B (p=0.024). Median OS was 10.3 months (95% CI: 8.8– 11.8) vs 7.4 months (95% CI: 6.9– 7.9), respectively (p=0.046). ORR was 34.0% vs 17.7% (p=0.048), and DCR was 74.0% vs 54.8% (p=0.036). Safety was comparable between cohorts, with no treatment-related deaths.
Conclusion: Cadonilimab plus chemotherapy significantly improved efficacy outcomes versus chemotherapy alone in patients with advanced G/GEJC after first-line immunotherapy progression, with a manageable safety profile. This suggests cadonilimab based therapy is a promising second-line strategy. Further prospective randomized studies are needed to confirm these findings.
Keywords: PD-1/CTLA-4 bispecific, cadonilimab, advanced gastroesophageal junction cancer, second-line treatment, efficacy, safety
Department of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ping Sun, Department of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, People’s Republic of China, Email sunping20039@hotmail.com Aina Liu, Department of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, People’s Republic of China, Email nana4312@sina.com
Background: Immunotherapy is now a cornerstone of first-line treatment for advanced gastric or gastroesophageal junction cancer (G/GEJC). However, optimal second-line options after progression on first-line immunotherapy are undefined. Given the established efficacy of cadonilimab in the first-line setting, this real-world study evaluated its combination with chemotherapy as a second-line treatment.
Methods: We conducted a single-center retrospective study of patients with advanced G/GEJC progressing after first-line immunotherapy. Patients received either cadonilimab plus chemotherapy (Cohort A, n=50) or chemotherapy alone (Cohort B, n=62) as second-line therapy between October 2022 and April 2025. The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and safety.
Results: Cohort A showed significantly improved outcomes. Median PFS was 4.9 months (95% CI: 3.9– 6.0) in Cohort A vs 3.8 months (95% CI: 2.8– 4.8) in Cohort B (p=0.024). Median OS was 10.3 months (95% CI: 8.8– 11.8) vs 7.4 months (95% CI: 6.9– 7.9), respectively (p=0.046). ORR was 34.0% vs 17.7% (p=0.048), and DCR was 74.0% vs 54.8% (p=0.036). Safety was comparable between cohorts, with no treatment-related deaths.
Conclusion: Cadonilimab plus chemotherapy significantly improved efficacy outcomes versus chemotherapy alone in patients with advanced G/GEJC after first-line immunotherapy progression, with a manageable safety profile. This suggests cadonilimab based therapy is a promising second-line strategy. Further prospective randomized studies are needed to confirm these findings.
Keywords: PD-1/CTLA-4 bispecific, cadonilimab, advanced gastroesophageal junction cancer, second-line treatment, efficacy, safety