Patient with HR-proficient advanced ovarian cancer achieved a complete response with Cadonilimab combined chemotherapy (PD-1/CTLA-4 bispecific): a case report and literature review

Objectives: For advanced ovarian cancer (OC), particularly OC with HR-deficient, surgery combined with adjuvant chemotherapy and maintenance therapy with PARPi/bevacizumab is the standard effective first-line treatment regimen. However, the clinical benefit of therapy for HR-proficient advanced OC i...

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Main Authors: Chenge Zhang, Miao Dai, Jun Yang, Wenfang Tian, Si Huang, Feng Bi, Kai Zheng, Jie Tang
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925001109
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author Chenge Zhang
Miao Dai
Jun Yang
Wenfang Tian
Si Huang
Feng Bi
Kai Zheng
Jie Tang
author_facet Chenge Zhang
Miao Dai
Jun Yang
Wenfang Tian
Si Huang
Feng Bi
Kai Zheng
Jie Tang
author_sort Chenge Zhang
collection DOAJ
description Objectives: For advanced ovarian cancer (OC), particularly OC with HR-deficient, surgery combined with adjuvant chemotherapy and maintenance therapy with PARPi/bevacizumab is the standard effective first-line treatment regimen. However, the clinical benefit of therapy for HR-proficient advanced OC is limited, with no significant increase in the 5-year survival rate. Methods: In this case study, a patient with Stage IVB OC, who tested HR-proficient, but PD-L1 positive, experienced significant tumor shrinkage (>90 %) after undergoing 3 cycles of neoadjuvant chemotherapy using TC (Paclitaxel with Carboplatin) with Cadonilimab (a PD-1/CTLA-4 bispecific antibody) therapy. Results: This resulted in an R0 resection during intermittent debulking surgery. After surgery, while the patient received standard first-line chemotherapy with TC + bevacizumab, the CA125 level failed to normalize. Nonetheless, upon readministration of Cadonilimab, CA125 levels normalized and have been maintained to date. The patient has remained free of recurrence and metastasis for more than 23 months after neoadjuvant therapy, before the data cutoff date, March 10, 2025. Conclusions: This case illustrates that individuals suffering from advanced OC, particularly those with HR-proficient and PD-L1 positive status, may benefit from first-line treatment with Cadonilimab. Identifying the population that may benefit from immune therapy is crucial. The novel PD-1/CTLA-4 bispecific antibody merits further attention for managing advanced epithelial ovarian cancer.Trial registration: NCT05430906, registration date: June 20,2022.
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spelling doaj-art-7fc276a5c6cb45b2a98a4d7c0e0e169f2025-08-21T04:17:03ZengElsevierGynecologic Oncology Reports2352-57892025-08-016010178510.1016/j.gore.2025.101785Patient with HR-proficient advanced ovarian cancer achieved a complete response with Cadonilimab combined chemotherapy (PD-1/CTLA-4 bispecific): a case report and literature reviewChenge Zhang0Miao Dai1Jun Yang2Wenfang Tian3Si Huang4Feng Bi5Kai Zheng6Jie Tang7Department of Obstetrics and Gynecology, Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China; Department of Gynecologic Oncology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, ChinaDepartment of Gynecologic Oncology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, ChinaDepartment of Gynecologic Oncology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, ChinaDepartment of Gynecologic Oncology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, ChinaDepartment of Gynecologic Oncology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, ChinaDepartment of Diagnostic Radiology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, ChinaPositron Emission Tomography/Computed Tomography (PET/CT) Center, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, ChinaDepartment of Obstetrics and Gynecology, Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China; Department of Gynecologic Oncology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, China; Corresponding author at: Department of Gynecologic Oncology, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, PR China.Objectives: For advanced ovarian cancer (OC), particularly OC with HR-deficient, surgery combined with adjuvant chemotherapy and maintenance therapy with PARPi/bevacizumab is the standard effective first-line treatment regimen. However, the clinical benefit of therapy for HR-proficient advanced OC is limited, with no significant increase in the 5-year survival rate. Methods: In this case study, a patient with Stage IVB OC, who tested HR-proficient, but PD-L1 positive, experienced significant tumor shrinkage (>90 %) after undergoing 3 cycles of neoadjuvant chemotherapy using TC (Paclitaxel with Carboplatin) with Cadonilimab (a PD-1/CTLA-4 bispecific antibody) therapy. Results: This resulted in an R0 resection during intermittent debulking surgery. After surgery, while the patient received standard first-line chemotherapy with TC + bevacizumab, the CA125 level failed to normalize. Nonetheless, upon readministration of Cadonilimab, CA125 levels normalized and have been maintained to date. The patient has remained free of recurrence and metastasis for more than 23 months after neoadjuvant therapy, before the data cutoff date, March 10, 2025. Conclusions: This case illustrates that individuals suffering from advanced OC, particularly those with HR-proficient and PD-L1 positive status, may benefit from first-line treatment with Cadonilimab. Identifying the population that may benefit from immune therapy is crucial. The novel PD-1/CTLA-4 bispecific antibody merits further attention for managing advanced epithelial ovarian cancer.Trial registration: NCT05430906, registration date: June 20,2022.http://www.sciencedirect.com/science/article/pii/S2352578925001109Advanced ovarian cancerAK104/CadonilimabPD-1/CTLA-4 bispecific antibodyComplete responseHR-proficient
spellingShingle Chenge Zhang
Miao Dai
Jun Yang
Wenfang Tian
Si Huang
Feng Bi
Kai Zheng
Jie Tang
Patient with HR-proficient advanced ovarian cancer achieved a complete response with Cadonilimab combined chemotherapy (PD-1/CTLA-4 bispecific): a case report and literature review
Gynecologic Oncology Reports
Advanced ovarian cancer
AK104/Cadonilimab
PD-1/CTLA-4 bispecific antibody
Complete response
HR-proficient
title Patient with HR-proficient advanced ovarian cancer achieved a complete response with Cadonilimab combined chemotherapy (PD-1/CTLA-4 bispecific): a case report and literature review
title_full Patient with HR-proficient advanced ovarian cancer achieved a complete response with Cadonilimab combined chemotherapy (PD-1/CTLA-4 bispecific): a case report and literature review
title_fullStr Patient with HR-proficient advanced ovarian cancer achieved a complete response with Cadonilimab combined chemotherapy (PD-1/CTLA-4 bispecific): a case report and literature review
title_full_unstemmed Patient with HR-proficient advanced ovarian cancer achieved a complete response with Cadonilimab combined chemotherapy (PD-1/CTLA-4 bispecific): a case report and literature review
title_short Patient with HR-proficient advanced ovarian cancer achieved a complete response with Cadonilimab combined chemotherapy (PD-1/CTLA-4 bispecific): a case report and literature review
title_sort patient with hr proficient advanced ovarian cancer achieved a complete response with cadonilimab combined chemotherapy pd 1 ctla 4 bispecific a case report and literature review
topic Advanced ovarian cancer
AK104/Cadonilimab
PD-1/CTLA-4 bispecific antibody
Complete response
HR-proficient
url http://www.sciencedirect.com/science/article/pii/S2352578925001109
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