What is cadonilimab, and why does the treatment setting matter?

Cadonilimab is a bispecific antibody that blocks PD-1 and CTLA-4, helping the immune system recognize and attack cancer cells. It is given by intravenous infusion. It is not chemotherapy or an ADC, and its evidence is distinct from combining two separate immunotherapy medicines.

The first step is to identify which setting below matches your situation. The same medicine has different partner drugs, evidence and care arrangements across cancers and treatment stages.

Check cervical cancer eligibility Check gastric cancer eligibility

Source [6]

When can it be considered for cervical or gastric cancer?

China has approved the following three uses. First-line means the initial systemic regimen for the relevant disease setting; it is not a simple count of every previous operation, radiotherapy course or chemotherapy treatment.

Three settings with different requirements
Setting	Approved regimen	Previous-treatment requirement
Persistent, recurrent or metastatic cervical cancer: first-line	Cadonilimab + paclitaxel + platinum, with or without bevacizumab.	Prior platinum failure is not required. Previous definitive chemoradiotherapy and the timing of recurrence still need review.
Recurrent or metastatic cervical cancer: after platinum failure	Cadonilimab alone.	Evidence of failure of prior platinum-containing chemotherapy is needed. Record previous immunotherapy and why it stopped.
Unresectable locally advanced or metastatic gastric/GEJ adenocarcinoma: first-line	Cadonilimab + fluoropyrimidine + platinum chemotherapy.	A first-line combination, not a general later-line monotherapy. The pivotal trial studied HER2-negative disease.

Can treatment actually be arranged in China?

These three uses are approved in China, so eligible patients can be assessed through routine hospital care rather than relying solely on a clinical trial. Chirona arranges specialist review at partner hospitals, then coordinates supply, the first infusion, tests and costs once the clinician agrees the regimen. We confirm the hospital, available dates and admission requirements before travel.

For cervical cancer, confirm monotherapy versus combination therapy and whether bevacizumab will be included. For gastric cancer, confirm the fluoropyrimidine/platinum regimen and maintenance plan. Approval in China does not establish local approval, supply or insurance coverage in your home country; continuing treatment there requires separate arrangements.

Source [1][2][3][6]

What benefits have studies shown, and which apply to me?

These two randomized trials studied first-line combinations. They support adding cadonilimab in the populations studied, but gastric results cannot predict cervical outcomes, and first-line results cannot establish the benefit of later-line monotherapy.

Read the evidence for your cancer
Study and population	Comparison and result	What it means
COMPASSION-16: 445 patients with persistent, recurrent or metastatic cervical cancer; Lancet 2024 report.	Adding cadonilimab to chemotherapy with or without bevacizumab improved median progression-free survival to 12.7 versus 8.1 months; overall survival also improved.	Supports the first-line combination. The median does not predict how long one person’s disease will remain controlled.
COMPASSION-15: 610 patients with HER2-negative advanced gastric/GEJ adenocarcinoma; Nature Medicine 2025 interim analysis.	Cadonilimab plus chemotherapy versus chemotherapy: median overall survival of 14.1 versus 11.1 months.	Supports first-line combination treatment in this population, alongside management of immune and chemotherapy side effects.

Is it better than other immunotherapy combinations?

These studies did not directly compare cadonilimab with another PD-1 medicine plus chemotherapy, so they do not establish which immune combination is best. The global gastric COMPASSION-37 trial began enrollment in September 2026 and includes a nivolumab-plus-chemotherapy comparator; enrollment is not an efficacy result. After progression on a PD-1 medicine, evidence for switching and alternative options need separate review.

Source [4][5][7]

Which tests and previous treatments affect eligibility?

Use the checklist for your cancer. Send the original reports you already have; you do not need to repeat tests on your own before contacting us.

Cervical cancer: first-line combination or post-platinum monotherapy?

Diagnosis and disease extent: Provide pathology, recent scans and records of persistent, recurrent or metastatic disease. These systemic regimens should not be applied automatically to early operable disease or a local recurrence still suitable for curative treatment.
Platinum history: List cisplatin, carboplatin or other agents, whether they accompanied radiotherapy, treatment dates, response and recurrence timing. Previous platinum exposure alone neither establishes post-platinum monotherapy eligibility nor automatically rules out a first-line combination.
Previous immune and other medicines: Record PD-1/PD-L1 agents, bevacizumab and ADCs, responses and reasons for stopping. Progression on immunotherapy or serious immune toxicity needs individual assessment; two targets do not guarantee reversal of resistance.
Whether to add bevacizumab: Report pelvic radiotherapy, bleeding, fistulas, blood clots, high blood pressure and recent surgery or healing wounds. Bevacizumab is optional and requires its own safety assessment.

Gastric cancer: confirm adenocarcinoma, first-line setting and HER2

Pathology and stage: Confirm gastric or gastroesophageal junction adenocarcinoma and unresectable locally advanced or metastatic disease. Gastric lymphoma, stromal tumors and other cancers in the stomach are not the same indication.
Treatment and recurrence timeline: Send surgery, perioperative chemotherapy, recurrence dates and all treatment for advanced disease. First-line refers to the current advanced-disease setting; progression after treatment in that setting cannot simply be relabeled as first-line eligibility.
Understand the HER2 evidence: The pivotal COMPASSION-15 trial studied HER2-negative disease. The current Chinese indication wording does not specify a HER2 cutoff, but this does not establish equivalent evidence in HER2-positive disease. A positive result requires comparison with HER2-targeted options; an unknown result is not negative.
Other tests and fitness: Send existing PD-L1 CPS, MSI/MMR and CLDN18.2 reports to help compare options, along with food intake, weight loss, anemia and liver/kidney function. The specialist determines further testing and fitness for the full regimen.

Can it be considered if PD-L1 is negative?

These Chinese approved indications do not require PD-L1 positivity, so a negative result alone is not a reason to rule out assessment. PD-L1 still helps compare alternatives. Tell the clinician about autoimmune disease, organ transplantation, serious previous immune side effects and current steroids or other immunosuppressants.

Cervical cancer: treatment after recurrence Gastric cancer: biomarkers and treatment options

Source [4][6][7]

How often is treatment given, and what needs monitoring?

Under the current Chinese prescribing information, post-platinum cervical monotherapy is usually infused every 2 weeks; first-line cervical and gastric combinations usually use a 3-week schedule. The clinician sets the plan using the prescription, tests and tolerance. Chemotherapy cycles, antibody infusions and total treatment duration are not interchangeable.

Before treatment, confirm blood counts, liver/kidney function and thyroid assessment, with repeat monitoring during care. The plan should state whether antibody or other maintenance treatment continues after chemotherapy and when scans are due; finishing chemotherapy does not automatically end all treatment.

Which symptoms should be reported before the next infusion?

Possible immune symptoms: Report new or worsening diarrhea, breathlessness, cough, jaundice, rash, unusual fatigue or marked thirst promptly. Immune effects can also occur after treatment stops.
Chemotherapy concerns: Fever, substantially reduced intake, persistent vomiting, numbness or bleeding need assessment rather than being dismissed as routine. Test results may require treatment to be delayed.
If bevacizumab is included: Follow the plan for blood pressure, urine protein, bleeding, wound healing and possible fistula symptoms.
Emergencies and care away from the treating hospital: Severe breathing difficulty, major bleeding or altered consciousness require emergency care. Keep the medicine list and contact details available, and tell other clinicians about dual checkpoint treatment.

Source [6][7]

What does it cost, and how do single-drug and combination plans differ?

US$13,000–60,000

What’s included

This estimate covers total medical treatment costs, including medication, specialist consultations and assessment, pretreatment tests, routine laboratory and imaging follow-up, treatment administration and nursing, necessary hospitalization and monitoring, and routine supportive care. Travel and accommodation are not included.

Your individual treatment costs

Post-platinum cervical monotherapy, cervical chemotherapy combinations with or without bevacizumab, and gastric chemotherapy combinations have different costs. Comparing one vial is not enough. The range is a planning estimate, not a fixed package or ceiling for every combination. Infusion numbers, maintenance, admission and complication care change the total. We help clarify itemized regimen costs, coordination fees and separately billed travel/accommodation, based on the treating hospital’s assessment.

How does Chirona arrange assessment, treatment and follow-up?

You can start with the records you have. We coordinate three steps so that, before travel, you understand the hospital, assessments, treatment plan and expected costs.

1. Organize records for the correct cancer and treatment setting

For cervical cancer, we organize platinum, radiotherapy, immunotherapy and bevacizumab history. For gastric cancer, we focus on adenocarcinoma pathology, HER2 and other reports, surgery/recurrence dates and advanced-disease treatment. Both need recent scans, tests, current medicines and important side effects. We identify gaps and arrange partner-hospital specialist review.

2. Confirm the full regimen, supply, dates and costs

Once the clinician determines monotherapy or a combination, we coordinate appointments, supply, pre-infusion tests and any necessary admission. We clarify what can be completed beforehand and what requires in-person assessment. Cost planning covers the full regimen, not just cadonilimab.

3. Arrange monitoring between cycles and handover at home

Agree where blood tests and urgent assessment for fever or immune symptoms will take place, when scans are due and how the next dose is decided. We help prepare Chinese and English treatment records for continuing care. If you plan further infusions at home, confirm the local clinician, lawful supply and costs before organizing the return.

Evidence & sources

Prepared by Chirona’s content team from the sources below. This guide supports a discussion with your treating team; it does not determine an individual treatment plan.