Head-to-Head Real-World Data: Cadonilimab Outperforms PD-1 Inhibitors in First-Line PD-L1-Low Gastric Cancer

Head-to-Head Real-World Data: Cadonilimab Outperforms PD-1 Inhibitors in First-Line PD-L1-Low Gastric Cancer

HONG KONG, Jan. 13, 2026 /PRNewswire/ -- Akeso, Inc. (9926.HK) announced the presentation of a real-world study at the 2026 American Society of Clinical Oncology 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).

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), 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.

Forward-Looking Statement of Akeso, Inc.
This announcement by Akeso, Inc. (9926.HK, "Akeso") contains "forward-looking statements". These statements reflect the current beliefs and expectations of Akeso's management and are subject to significant risks and uncertainties. These statements are not intended to form the basis of any investment decision or any decision to purchase securities of Akeso. There can be no assurance that the drug candidate(s) indicated in this announcement or Akeso's other pipeline candidates will obtain the required regulatory approvals or achieve commercial success. If underlying assumptions prove inaccurate or risks or uncertainties materialize, actual results may differ materially from those set forth in the forward-looking statements.

Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation in P.R.China, the United States and internationally; global trends toward health care cost containment; technological advances, new products and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approval; Akeso's ability to accurately predict future market conditions; manufacturing difficulties or delays; financial instability of international economies and sovereign risk; dependence on the effectiveness of the Akeso's patents and other protections for innovative products; and the exposure to litigation, including patent litigation, and/or regulatory actions.

Akeso does not undertake any obligation to publicly revise these forward-looking statements to reflect events or circumstances after the date hereof, except as required by law.

About Akeso
Akeso (HKEX: 9926.HK) is a leading biopharmaceutical company committed to the research, development, manufacturing and commercialization of the world's first or best-in-class innovative biological medicines. Founded in 2012, the company has created a unique integrated R&D innovation system with the comprehensive end-to-end drug development platform (ACE Platform) and bi-specific antibody drug development technology (Tetrabody) as the core, a GMP-compliant manufacturing system and a commercialization system with an advanced operation mode, and has gradually developed into a globally competitive biopharmaceutical company focused on innovative solutions. With fully integrated multi-functional platform, Akeso is internally working on a robust pipeline of over 50 innovative assets in the fields of cancer, autoimmune disease, inflammation, metabolic disease and other major diseases. Among them, 26 candidates have entered clinical trials (including 15 bispecific/multispecific antibodies and bispecific ADCs. Additionally, 7 new drugs are commercially available. Through efficient and breakthrough R&D innovation, Akeso always integrates superior global resources, develops the first-in-class and best-in-class new drugs, provides affordable therapeutic antibodies for patients worldwide, and continuously creates more commercial and social values to become a global leading biopharmaceutical enterprise.

For more information, please visit https://www.akesobio.com/en/about-us/corporate-profile/ and follow us on Linkedin.

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