On January 13, 2026 Akeso, Inc. (9926.HK) reported the presentation of a real-world study at the 2026 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Gastrointestinal Cancers Symposium (ASCO GI), comparing cadonilimab plus chemotherapy against a PD-1 inhibitor plus chemotherapy for the first-line (1L) treatment for advanced gastric (G) or gastroesophageal junction (GEJ) cancer with PD-L1 CPS <5 (a propensity-matched, retrospective cohort study).
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The study results showed that the cadonilimab regimen, compared to the PD-1 monoclonal antibody regimen, significantly prolonged patients’ overall survival (OS) and progression-free survival (PFS). Both OS (HR=0.49, P=0.025) and PFS (HR=0.43, P=0.006) demonstrated statistically significant improvements. The full study has been accepted for publication in the Journal of Gastrointestinal Oncology.
These real-world findings are highly consistent with the "all-comer benefit" profile previously observed for cadonilimab in the Phase III registrational trial COMPASSION-15. This real-world, head-to-head comparison further underscores cadonilimab’s potential to elevate the standard of cancer immunotherapy and address clinical challenges unresolved by single-target PD-1 inhibitors. Based on the data from the pivotal Phase III COMPASSION-15 study, cadonilimab received approval in China in September 2024 for the first-line treatment of advanced gastric cancer across all patient subgroups and this indication was added to cadonilimab’s list of covered indication under National Reimbursement Drug List (NRDL), effective 2026.
Anti-PD-1 antibodies combined with chemotherapy is the international standard of care for advanced gastric cancer. However, its efficacy is significantly limited in patients with PD-L1-low (CPS < 5) or negative (CPS < 1) expression, where these patients constitute nearly half of all advanced gastric cancer cases. As a result, the U.S. Food and Drug Administration (FDA) restricted all approved first-line PD-1 inhibitors for advanced gastric cancer to only PD-L1-positive patients in 2024. This aligns with recommendations from leading guidelines, such as those of the National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper), which prioritize PD-1-based regimens for patients with PD-L1 CPS ≥5. Consequently, PD-L1-low or -negative advanced gastric cancer remains a major unmet clinical need globally due to thelack of effective immunotherapy options. A recent real-world study provides new evidence addressing this challenge.
In this retrospective analysis, patients with PD-L1-low (CPS < 5) advanced G/GEJ cancer received first-line therapy with either cadonilimab plus chemotherapy or a PD-1 inhibitor plus chemotherapy. With a median follow-up of 11.0 months as of February 28, 2025, the results showed that the cadonilimab-based regimen achieved statistically significant and clinically meaningful improvements in both PFS and OS compared to the PD-1 inhibitor-based regimen.
Some Key Findings from the Study published at GI-ASCO:
Significant PFS and OS Improvement: Among PD-L1-low patients, the cadonilimab group achieved a median OS of 14.3 months, significantly longer than the 10.3 months observed in the PD-1 inhibitor group (OS HR=0.49, p=0.025), representing a 51% reduction in the risk of death. The median PFS was also extended to 9.3 months compared to 5.8 months in the control group (PFS HR=0.43, p=0.006), corresponding to a 57% reduction in the risk of disease progression or death.
Higher Objective Response Rate (ORR): The objective response rate was superior in the cadonilimab group compared to the PD-1 inhibitor group (73.3% vs. 57.1%) for PD-L1-low patients.
Manageable Safety and Good Tolerability: The incidence of any-grade adverse events was comparable between the two groups, and no statistically significant difference observed in the rate of grade 3-4 adverse events between the two groups.
Akeso is actively advancing several prospective head-to-head Phase III registration studies with cadonilimab, aiming to elevate current standard immunotherapies. Notably, the international multi-center Phase III registration study COMPASSION-37, evaluating cadonilimab plus chemotherapy versus the PD-1 inhibitor nivolumab plus chemotherapy for first-line treatment of advanced gastric cancer, received approval from the U.S. FDA to initiate at the end of 2025. This milestone marks a new phase in the global development of cadonilimab.
(Press release, Akeso Biopharma, JAN 13, 2026, View Source [SID1234662024])