CASE REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1652827
This article is part of the Research TopicCheckpoint Immunotherapy: Reshaping the Landscape of Gastrointestinal Cancer Treatment - Volume IIView all articles
Efficacy of Cadonilimab in Combination with Nimotuzumab and AG Regimen in TMB-H/KRAS Wild-Type Advanced Pancreatic Cancer: A Case Report
Provisionally accepted
- 1Hubei University of Medicine, Shiyan, China
- 2Wuhan University, Wuhan, China
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Background: Advanced pancreatic cancer carries a dismal prognosis. Current chemotherapy provides limited survival benefit while causing substantial toxicity. Despite numerous trials, combining gemcitabine with other cytotoxic or targeted agents has not significantly improved outcomes, highlighting the urgent need for novel therapeutic strategies. Case presentation: This report describes a 56-year-old male diagnosed with stage IVB pancreatic tail adenocarcinoma, characterized by a high tumor mutational burden (TMB-H) and a KRAS wild-type status. The patient showed a significant therapeutic response and an improved quality of life after receiving a novel four-drug combination regimen. The treatment included cadonilimab (a PD-1/CTLA-4 bispecific antibody), nimotuzumab (an EGFR monoclonal antibody), albumin-bound paclitaxel, and gemcitabine. After two cycles, the primary pancreatic lesion reduced by 37%, and there was substantial shrinkage of hepatic metastases. Continued treatment maintained partial remission (PR), with progression-free survival (PFS) lasting over seven months and manageable toxicity. Conclusion: This case highlights the potential of the combination of cadonilimab, nimotuzumab, albumin-bound paclitaxel, and gemcitabine as an effective, low-toxicity treatment option for patients with TMB-H/KRAS wild-type advanced pancreatic cancer.
Keywords: Advanced pancreatic cancer, tumor mutational burden (TMB-H), KRAS wild-type, Cadonilimab, nimotuzumab
Received: 24 Jun 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Tang, Hu, He and Dongdong. 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: Zhang Dongdong, zhangdongdong@whu.edu.cn
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