Zhang Chenge, Dai Miao, Yang Jun, Tian Wenfang, Huang Si, Bi Feng, Zheng Kai, Tang Jie
Department 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.
Gynecol Oncol Rep. 2025 Jun 15;60:101785. doi: 10.1016/j.gore.2025.101785. eCollection 2025 Aug.
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.
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.
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.
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. NCT05430906, registration date: June 20,2022.
对于晚期卵巢癌（OC），尤其是同源重组缺陷型OC，手术联合辅助化疗以及PARPi/贝伐单抗维持治疗是标准有效的一线治疗方案。然而，同源重组 proficient 型晚期OC治疗的临床获益有限，5年生存率无显著提高。
在本病例研究中，一名IVB期OC患者，检测为同源重组 proficient 型，但程序性死亡受体配体1（PD-L1）阳性，在接受3个周期使用TC（紫杉醇联合卡铂）加卡度尼利单抗（一种PD-1/细胞毒性T淋巴细胞相关蛋白4双特异性抗体）的新辅助化疗后，肿瘤显著缩小（>90%）。
这使得在间歇性减瘤手术中实现了R0切除。术后，患者接受TC + 贝伐单抗标准一线化疗时，癌抗原125（CA125）水平未恢复正常。尽管如此，再次使用卡度尼利单抗后，CA125水平恢复正常并维持至今。在新辅助治疗后，截至数据截止日期2025年3月10日，患者已超过23个月无复发和转移。
本病例表明，晚期OC患者，尤其是同源重组 proficient 型且PD-L1阳性者，可能从卡度尼利单抗一线治疗中获益。确定可能从免疫治疗中获益的人群至关重要。新型PD-1/细胞毒性T淋巴细胞相关蛋白4双特异性抗体在晚期上皮性卵巢癌治疗中值得进一步关注。NCT05430906，注册日期：2022年6月20日。
