Abstract
BACKGROUND: Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy, but immune-related hypersensitivity reactions remain a clinical concern. Cadonilimab, a novel PD-1/CTLA-4 bispecific antibody, has demonstrated encouraging antitumor efficacy across various solid tumors; however, hypersensitivity or infusion-related reactions may occasionally occur. METHODS: We herein report five cases of cadonilimab-induced allergic or infusion-related reactions in patients with different advanced solid tumors. Clinical manifestations ranged from mild skin rash to severe anaphylaxis with hypotension. All patients were managed promptly with individualized anti-allergic interventions, and some were able to safely continue therapy with modified infusion protocols. RESULTS: The series emphasizes the importance of early identification and tailored management of hypersensitivity reactions during cadonilimab treatment. Additionally, a comprehensive literature review was conducted summarizing current clinical trials, case reports, and real-world evidence regarding cadonilimab's efficacy and safety across multiple cancer types. CONCLUSION: Our findings highlight both the potential risks and manageable nature of cadonilimab-induced hypersensitivity, supporting its continued clinical application with appropriate monitoring and management strategies.