主要研究结果:
• 共纳入610例初治、不可切除局部晚期或转移性胃/GEJ腺癌
• 按1:1的比例随机分为卡度尼利单抗10mg/kg Q3W或安慰剂联合化疗Q3W(305/305)
• 主要终点为OS(ITT人群,单侧显著性水平P=0.025)
• 中位随访18.7个月,卡度尼利单抗组显著延长中位OS,分别为14.1与11.1个月(HR=0.66; 95%CI:0.54-0.81; P<0.001),达到主要终点
• PD-L1 CPS≥5:卡度尼利单抗组与安慰剂组的中位OS分别为15.3与10.9个月(HR=0.58; 95%CI:0.41-0.82)
• 卡度尼利单抗组与安慰剂组:
• 中位PFS分别为7.0与5.3个月(HR=0.53; 95%CI:0.44-0.65)
• ORR分别为65.2%与48.9%,中位DOR分别为8.8与4.4个月
• ≥3级TRAE分别为65.9%与53.6%,最常见为血小板计数减少、中性粒细胞计数减少和贫血
• 大部分irAE为1或2级,未观察到新的安全性信号
参考文献:
Shen L, Zhang Y, Li Z, Zhang X, Gao X, Liu B, Wang Y, Ba Y, Li N, Zhang R, Zhang J, Chen Y, Chen J, Huang M, Fu Y, Liu M, Liu Z, Zhao J, Li W, Wei J, Li C, Xu N, Guo Z, Cao B, Liu L, Nie P, Wan L, Sheng L, Liu Z, He Y, Gu K, Wu G, Wang W, Zhang F, Qiu W, Guo J, Ying J, Pan H, Xu H, Yuan Y, Bai Y, Wang Z, Xu J, Zhao X, Liu H, Zhang X, Dai W, Xu H, Liu M, Xie L, Tang Y, Jin J, Qu X, Fang X, Huang M, Chen H, Zheng Z, Wang Y, Wang D, Li X, Yu G, Liu H, Zhou Y, Zhong D, Zeng S, Kang M, Wang M, Gao Y, Li W, Wang Z, Zhang M, Zhang J, Li Q, Sun S, Zang A, Lin L, Xie M, Zhuang Z, Zhang T, Yao Z, Lu D, Liu W, Hu M, Wang ZM, Li B, Xia M, Zhang J, Ying X, Pardoll DM, Ji J. First-line cadonilimab plus chemotherapy in HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma: a randomized, double-blind, phase 3 trial. Nat Med. 2025 Jan 22. doi: 10.1038/s41591-024-03450-4. Epub ahead of print. PMID: 39843940.