1. Cadonilimab plus chemotherapy significantly improved progression-free survival in patients with persistent, recurrent, or metastatic cervical cancer.

2. Common grade 3 or higher adverse events included neutropenia, leukopenia, and anemia.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Standard platinum-based chemotherapy is the first-line treatment for patients with persistent, recurrent, or metastatic cervical cancer. Cadonilimab is a bispecific antibody targeting PD-1 and CTLA-4, which has demonstrated significant clinical benefits in patients with advanced cervical cancer. However, there is a paucity of research on the use of cadonilimab in persistent, recurrent, or metastatic cervical cancer. This randomized controlled trial aimed to assess whether the addition of cadonilimab could improve survival outcomes compared to chemotherapy alone. The primary outcome of this study was progression-free survival, while a key secondary outcome was overall survival. According to study results, cadonilimab significantly extended progression-free survival and overall survival compared to the placebo group. Although this study was well done, it was limited to a single country, affecting the generalizability of results.

Click to read the study in The Lancet

Relevant Reading: Pembrolizumab for Persistent, Recurrent, or Metastatic Cervical Cancer

In-depth [randomized-controlled trial]: Between Sept 11, 2021, and Jun 23, 2022, 623 patients were screened for eligibility across 59 clinical sites in China. Included were patients ≥ 18 years old with untreated persistent, recurrent, or metastatic cervical cancer. Altogether, 445 patients (222 in cadonilimab and 223 in placebo) were included in the final analysis. The primary outcome of median progression-free survival was significantly greater in the cadonilimab group compared to placebo (12.7 months vs. 8.1 months, hazard ratio [HR] 0.62, p<0.0001). The secondary outcome also favored cadonilimab, with the median overall survival not reached but trending longer than in the placebo group (27.0 months vs. 22.8 months, HR 0.64, p=0.0011). Findings from this study suggest that cadonilimab combined with chemotherapy offers a promising first-line treatment for advanced cervical cancer.

Image: PD

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