Cadonilimab (PD-1/CTLA-4) in Combination with Lenvatinib in Unresectable Hepatocellular Carcinoma (uHCC): A Retrospective Real-world Study

Overview

Journal Heliyon

Specialty Social Sciences

Date 2024 Oct 14

PMID 39398001

Authors

Guosheng Yuan

Yongru Chen

Peilin Zhu

Qiong Deng

Kaiyan Su

Jie Liu

Yan Wang

Rong Li

Wenli Li

Mengya Zang

Xiaoyun Hu

Jun-Jie Wang

Qi Li

Yangfeng Du

Jinzhang Chen

Affiliations

Soon will be listed here.

Abstract

Background: Previous research has shown that combining tyrosine kinase inhibitors (TKIs) with immunotherapy results in synergistic clinical efficacy. Cadonilimab, the first approved bi-specific antibody targeting PD-1 and CTLA-4, was studied to evaluate its efficacy and safety in combination with Lenvatinib as a first-line treatment for patients with unresectable hepatocellular carcinoma (uHCC).

Methods: A retrospective study was conducted on 29 uHCC patients diagnosed at Nanfang Hospital, Southern Medical University, between July 7, 2022, and March 3, 2023. Patients received Cadonilimab (10 mg/kg, IV, every 3 weeks) combined with Lenvatinib (8 mg, orally, daily). The primary endpoint was the objective response rate (ORR), with secondary endpoints including disease control rate (DCR), median progression-free survival (mPFS), median overall survival (mOS), median time to progression (mTTP), and safety.

Results: By April 2023, 29 patients had been enrolled in the study. The ORR was 37.9 %, DCR was 82.8 %, mPFS was 8.1 months, mTTP was 8.2 months, and mOS was not reached. A total of 93.1 % of patients experienced at least one treatment-related adverse event (TRAE). The most common adverse events were weight loss (51.7 %), increased aspartate aminotransferase (48.3 %), leukocytopenia (48.3 %), and neutropenia (48.3 %). TRAEs of grade 3 or higher occurred in 51.7 % of patients, with no grade 4 TRAEs observed.

Conclusion: This study demonstrated the efficacy and safety of this combination, potentially improving outcomes as a first-line therapy, and offering a novel therapeutic approach for advanced HCC.

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