A surprising complete response to cadonilimab in a primary metastatic cervical cancer: a case report

Front Immunol. 2024 Nov 26:15:1494138. doi: 10.3389/fimmu.2024.1494138. eCollection 2024.

Abstract

The outcome of patients with recurrent/metastatic cervical cancer (R/M CC) is poor, with a 5-year survival rate of only 10%-20%. Recent advances in immunotherapy renewed its interest in R/M CC treatment. It has been suggested that cadonilimab, a novel bispecific antibody targeting programmed death 1 (PD-1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4), significantly improved the survival outcomes of the R/M CC. In the present study, we reported a programmed death ligand 1 (PD-L1) and human epidermal growth factor receptor 2 (HER-2) positive CC case at stage IV who was treated with cadonilimab and achieved a surprising radiographic complete response (CR) for 10 months, even in the PD-L1 negative metastatic site. Demographic, clinical, histopathological, laboratory, treatment regime and imaging data were recorded. Unfortunately, the patient progressed rapidly during maintenance therapy when cadonilimab was replaced by sintilimab, the monoclonal antibody against PD-1, indicating the more powerful anti-tumor activity of dual blockade immunotherapy. To conclude, cadonilimab offers a promising and effective therapeutic approach for R/M CC. Notably, HER-2 is also expected to be a new reference target for cadonilimab therapy.

Keywords: HER-2; cadonilimab; case report; complete response; recurrent and/or metastatic cervical cancer.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Bispecific / therapeutic use
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Antineoplastic Agents, Immunological / therapeutic use
  • B7-H1 Antigen / antagonists & inhibitors
  • CTLA-4 Antigen / antagonists & inhibitors
  • CTLA-4 Antigen / immunology
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Metastasis
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Programmed Cell Death 1 Receptor / immunology
  • Receptor, ErbB-2 / antagonists & inhibitors
  • Receptor, ErbB-2 / metabolism
  • Treatment Outcome
  • Uterine Cervical Neoplasms* / drug therapy
  • Uterine Cervical Neoplasms* / pathology

Substances

  • Antibodies, Monoclonal, Humanized
  • B7-H1 Antigen
  • Receptor, ErbB-2
  • Antibodies, Bispecific
  • Programmed Cell Death 1 Receptor
  • CD274 protein, human
  • ERBB2 protein, human
  • Antineoplastic Agents, Immunological
  • CTLA-4 Antigen

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Major Scientific Research Program for Young and Middle-aged Health Professionals of Fujian Province, China (Grant No. 2022ZQNZD008), the High-level Talents Training Project of Fujian Cancer Hospital (Grant No.2022YNG04) and the Joint Funds for the Innovation of Science and Technology, Fujian Province (Grant No.2023Y9404).