ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1634779
This article is part of the Research TopicEvolving Therapies in Gynecological Oncology: From Chemotherapy to Personalized MedicineView all articles
First-line treatment with cadonilimab plus paclitaxel-platinum ± bevacizumab for persistent, recurrent, or metastatic cervical cancer: a retrospective real-world study
Provisionally accepted
- Jiangsu Cancer Hospital, Nanjing Medical University, Nanjing, China
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Background: To assess the real-world effectiveness and safety of first-line treatment with cadonilimab plus paclitaxel-platinum ± bevacizumab for persistent, recurrent, or metastatic cervical cancer (p/r/m CC).In this retrospective real-world study from Jiangsu Cancer Hospital (January 2021-February 2025), patients with p/r/m CC received first-line cadonilimab plus paclitaxel-platinum ± bevacizumab or paclitaxel-platinum ± bevacizumab. Co-primary endpoints were progression-free survival (PFS) and safety; overall survival (OS), objective response rate (ORR), and disease-control rate (DCR) were secondary. Kaplan-Meier and log-rank methods were applied, with prognostic factors analyzed using Cox models.Results: Among 169 eligible patients (50 cadonilimab plus TP; 119 TP), median follow-up was 33.2 months (IQR: 12.2-35.2). Cadonilimab addition significantly prolonged mPFS (20.2 vs. 12.2 months; HR: 0.531, P = 0.019), with 12-and 24-month PFS rates of 65.83% and 48.62% versus 50.71% and 29.57%, respectively. ORR improved from 40.3% to 58.0%, while DCR remained high in both cohorts (96.0% vs. 90.8%). mOS was not reached in the cadonilimab plus TP group and was 37.5 months with TP alone. Cadonilimab increased low-grade immune-related or gastrointestinal adverse events, with the most common being rash or itching (38.0%), pyrexia (32.0%), constipation (58.0%), and diarrhea (50.0%). However, events in grade 3-5 were infrequent. Subgroup analyses showed a generally consistent PFS benefit with cadonilimab across most predefined patient subsets.In real-world clinical settings, cadonilimab plus TP ± bevacizumab provides a durable PFS benefit with acceptable safety and supports first-line use for p/r/m CC; additional follow-up is essential to determine its impact on OS.
Keywords: Cadonilimab, Immunotherapy, cervical cancer, Progression-free survival, adverse events
Received: 25 May 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 Wang, Wang, Zong, Zhu and He. 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:
Biqing Zhu, Jiangsu Cancer Hospital, Nanjing Medical University, Nanjing, China
Xia He, Jiangsu Cancer Hospital, Nanjing Medical University, Nanjing, China
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