{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:57:03Z","timestamp":1790618223605,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82102781"],"award-info":[{"award-number":["82102781"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The FDA Oncologic Drugs Advisory Committee (ODAC) highlighted that the risk\u2013benefit profile for patients with low PD\u2010L1 expression remains unclear in front\u2010line treatment of HER2\u2010negative gastric and gastroesophageal junction (GC\/GEJ) cancer with PD\u2010(L)1 therapy. The first PD\u20101\/CTLA\u20104 bispecific antibody (BsAb), cadonilimab, has been approved, but it is unknown if it can extend the PD\u2010(L)1 regimen to lower PD\u2010L1 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To indirectly compare the survival outcomes of cadonilimab versus PD\u2010(L)1 therapy in first\u2010line HER2\u2010negative gastric and gastroesophageal junction cancer, with particular focus on patients with low PD\u2010L1 expression, using a network meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomized controlled trials with ICIs as first\u2010line treatment were searched in public databases and FDA ODAC up to December 31, 2024. A network meta\u2010analysis was conducted to evaluate the efficacy and safety of approved ICI\u2010based treatments to refine the optimal approach for front\u2010line GC\/GEJ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 7127 patients from eight Phase III trials were included. All ICIs\u2010based therapies significantly improved overall survival (OS) compared to chemotherapy. In indirect comparisons, cadonilimab plus XELOX was associated with numerically more favorable OS (HR\u2009=\u20090.78, 95% CI: 0.62\u20130.98) compared with PD\u2010(L)1 inhibitors. Numerical trends toward longer survival were observed across subgroups, including patients with PD\u2010L1\u2009&lt;\u200910 (HR\u2009=\u20090.77, 95% CI: 0.58\u20131.01) and liver metastasis (HR\u2009=\u20090.67, 95% CI: 0.49\u20130.93), both historically considered immunotherapy\u2010insensitive populations. All ICIs improved PFS compared to chemotherapy. Cadonilimab was associated with numerically better PFS versus PD\u2010(L)1 inhibitors in indirect comparisons (HR\u2009=\u20090.70, 95% CI: 0.57\u20130.86). The safety analysis showed no significant increase in severe adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this indirect comparison, cadonilimab showed more favorable survival outcomes versus PD\u2010(L)1 inhibitors in first\u2010line GC\/GEJ. Subgroup benefits were observed in liver metastasis, while the PD\u2010L1\u2009&lt;\u200910 subgroup showed numerical trends. These results highlight the importance of selecting appropriate ICIs to optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cnr2.70672","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T02:46:56Z","timestamp":1789526816000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Survival Outcomes With Cadonilimab Versus\n                    <scp>PD<\/scp>\n                    \u2010(L)1 Therapy in Front\u2010Line Gastric Cancer: A Network Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7966-4015","authenticated-orcid":false,"given":"Zi\u2010Kun","family":"Yu","sequence":"first","affiliation":[{"name":"VIP Region Sun Yat\u2010Sen University Cancer Center  Guangzhou Guangdong China"},{"name":"State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine Sun Yat\u2010Sen 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