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Cadonilimab is a tetravalent, bispecific monoclonal antibody that targets both programmed cell death protein 1 (PD-1) and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), two key immune checkpoints involved in tumor immune evasion. By simultaneously blocking PD-1 and CTLA-4 pathways, cadonilimab activates T cells, increasing interleukin‑2 (IL‑2) and interferon‑γ (IFN‑γ) secretion, thereby enhancing anti-tumor immunity. The drug is engineered to eliminate Fc receptor binding to reduce antibody-dependent cellular cytotoxicity and complement-mediated cytotoxic effects, which may lower toxicity compared to traditional checkpoint inhibitors[5][6]. Cadonilimab has demonstrated efficacy as monotherapy and in combination with chemotherapy for various cancers including cervical cancer and gastric cancer. It was developed by Akeso Biopharma and is approved in China for recurrent/metastatic cervical cancer as second-line therapy; it has also been approved for first-line treatment of advanced gastric cancer[2][3][4][8].
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