{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:52:00Z","timestamp":1791525120495,"version":"4.3.4"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the clinical characteristics of infusion-related reactions (IRRs) associated with cadonilimab in a real-world cohort and propose preliminary management considerations based on these observations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A descriptive retrospective case series was conducted, involving data collection from 52 patients who received cadonilimab and subsequently experienced infusion-related reactions at a tertiary hospital between July 2022 and December 2025. Patients were classified into a common IRR group (n=31) and a severe IRR group (n=21) based on the severity criteria outlined in CTCAE 6.0. We conducted a comparative analysis of baseline characteristics, IRR onset timing, clinical manifestations, management strategies, and outcomes between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median time to IRR onset was 20 minutes post-infusion, with the highest proportion of recorded IRR cases occurring during the second treatment cycle (42.3%). Severe IRR manifested as multi-organ involvement in 61.9% of cases, predominantly affecting the respiratory and cardiovascular systems. Patients with severe IRR more frequently received corticosteroids combined with antihistamines (57.1% vs. 29.0%) and had higher rates of premedication (76.2% vs. 45.2%). Twenty-four patients (46.2%) attempted same-cycle infusion resumption; among these, 15 (62.5%) successfully completed the infusion without symptom recurrence. Among the 10 severe-group patients who attempted same-cycle infusion resumption, 6 (60.0%) experienced recurrent symptoms; among all 21 severe-group patients, the recurrence rate was 28.6% (6\/21). The clinically relevant same-cycle recurrence rates were 9\/24 overall (37.5%), 3\/14 (21.4%) in the common group, and 6\/10 (60.0%) in the severe group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cadonilimab is associated with early-onset infusion-related reactions frequently involving multiple organ systems. Based on our institutional experience, we propose a preliminary management framework that requires prospective validation before it can be recommended for routine clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1815365","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:33:20Z","timestamp":1791524000000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics of cadonilimab-associated infusion reactions: a severity-stratified analysis of 52 cases and preliminary management framework"],"prefix":"10.3389","volume":"17","author":[{"given":"Jinlan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The People\u2019s Hospital of Jianyang City","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guisen","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Yantai Traditional Chinese Medicine Hospital","place":["Yantai, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Urology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.2147\/tcrm.S204909","article-title":"The importance of early identification of infusion-related reactions to monoclonal antibodies","volume":"15","author":"C\u00e1ceres","year":"2019","journal-title":"Ther Clin Risk Manag"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-022-01761-9","article-title":"Cadonilimab: first approval","volume":"82","author":"Keam","year":"2022","journal-title":"Drugs"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2024.102922","article-title":"Management of infusion-related reactions in cancer therapy: Strategies and challenges","volume":"9","author":"Barroso","year":"2024","journal-title":"ESMO Open"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx216","article-title":"Management of infusion reactions to systemic anticancer therapy: ESMO clinical practice guidelines","volume":"28","author":"Rosell\u00f3","year":"2017","journal-title":"Ann Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1159\/000535504","article-title":"Infusion-related reactions induced by cadonilimab (PD-1\/CTLA-4 bispecific antibody): Seven case reports","volume":"17","author":"Liang","year":"2024","journal-title":"Case Rep Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2026.1043","article-title":"A dermatologist's perspective on cutaneous adverse effects in CTCAE version 6.0","volume":"12","author":"Gulati","year":"2026","journal-title":"JAMA Oncol"},{"key":"B7","volume-title":"Specification for Adverse Drug Reaction\/Event Causality Assessment. 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