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CASE REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 |
doi: 10.3389/fimmu.2025.1533700
Combination of cadonilimab(PD-1/CTLA-4 Bispecific Antibody) and Apatinib as Salvage Therapy Achieves Partial Response in MSI-H Advanced Gastric Cancer：A case report
Provisionally accepted- 1 Shouguang People's Hospital, Weifang, China
- 2 The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
- 3 Qingdao University, Qingdao, Shandong Province, China
- 4 Shandong First Medical University, Tai'an, Shandong, China
Microsatellite instability-high (MSI-H) gastric cancer(GC) is recognized as a unique subtype of gastric cancer. While patients with advanced MSI-H gastric cancer may respond favorably to a combination of immune checkpoint inhibitors and chemotherapy in first-line treatment, no definitive recommendations exist regarding the optimal regimen for subsequent therapy. Cadonilimab, a PD-1 and CTLA-4 bispecific antibody, has shown encouraging efficacy and safety in the first-line treatment of advanced gastric cancer. However, its utility in the MSI-H gastric cancer subtype following multiple lines of therapy remains uncertain. This case report describes a patient with advanced MSI-H gastric adenocarcinoma that progressed after multiple treatments and achieved notable efficacy with a combination of cadonilimab and apatinib. By examining the current therapeutic landscape for MSI-H gastric cancer, this study explores the potential of combining PD-1/CTLA-4 dual-immunity with anti-vascular therapy as salvage treatment for this gastric cancer subtype. The findings provide valuable reference points for future clinical trials, offering a promising perspective on backline therapeutic strategies for MSI-H gastric cancer and highlighting the potential of integrating bispecific antibodies with anti-vascular therapies.
Keywords: PD-1/CTLA-4 bispecific antibody, AK104/cadonilimab, Microsatellite Instability, Apatinib, Salvage Therapy, Advanced gastric cancer
Received: 24 Nov 2024; Accepted: 31 Jan 2025.
Copyright: © 2025 Zhao, Li, Sun, Xiao, Xue, Sui and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaoxiao Li, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
Xiaoyuan Sun, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
Ruoxi Xiao, Qingdao University, Qingdao, 266071, Shandong Province, China
Juan Xue, Qingdao University, Qingdao, 266071, Shandong Province, China
Kexin Sui, Shandong First Medical University, Tai'an, 271000, Shandong, China
Zimin Liu, The Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China
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