Supplementary Material for: Infusion-Related Reactions Induced by Cadonilimab (PD-1/CTLA-4 Bispecific Antibody): Seven Case Reports

<b><i>Introduction:</i></b> Cadonilimab (AK104) is an innovative human programmed cell death-1 (PD-1)/cytotoxic T lymphocyte antigen-4 (CTLA-4) bispecific antibody. Compared with the combination therapy of PD-1 and CTLA-4 blockers, less cellular toxicity of cadonilimab was significantly manifested. As one of the characteristic adverse effects of cadonilimab, infusion-related reactions (IRRs) represent fever, chills, rash, decreased blood pressure, and other symptoms. <b><i>Case Presentation:</i></b> Here, we documented seven cases of IRRs after the administration of cadonilimab. The symptoms of IRRs were relieved after the discontinuation of cadonilimab and the administration of diphenhydramine, dexamethasone, and cimetidine. Notably, 3 patients were able to tolerate the subsequent cadonilimab therapy under the pretreatment. <b><i>Conclusion:</i></b> In this study, we discovered that cadonilimab-related IRRs might be lessened or prevented by administering medication and the proper pretreatment and lowering the infusion rate.

<b><i>引言：</i></b> 卡度尼利单抗（Cadonilimab, AK104）是一款创新性人源化程序性细胞死亡蛋白1（programmed cell death-1, PD-1）/细胞毒性T淋巴细胞相关抗原4（cytotoxic T lymphocyte antigen-4, CTLA-4）双特异性抗体。相较于PD-1与CTLA-4抑制剂的联合治疗方案，卡度尼利单抗的细胞毒性显著更低。输液相关反应（infusion-related reactions, IRRs）作为卡度尼利单抗的特征性不良反应之一，表现为发热、寒战、皮疹、血压下降等症状。<b><i>病例报告：</i></b> 本文共报道7例应用卡度尼利单抗后出现输液相关反应的病例。在停用卡度尼利单抗并给予苯海拉明、地塞米松及西咪替丁治疗后，所有输液相关反应症状均得到缓解。值得注意的是，其中3例患者在接受预处理后可耐受后续的卡度尼利单抗治疗。<b><i>结论：</i></b> 本研究证实，通过药物干预、合理预处理以及降低输注速率，可减轻或预防卡度尼利单抗相关的输液相关反应。