Cantargia’s Nadunolimab Emerges as Potential Game-Changer in Oncology: Combating CIPN While Fighting Cancer

Chemotherapy-induced peripheral neuropathy (CIPN)—a debilitating side effect marked by pain, numbness, and weakness in extremities—has long plagued cancer patients, often forcing dose reductions or treatment discontinuation. Now, Swedish biotech Cantargia AB (CTRA) has unveiled promising data suggesting its experimental drug, nadunolimab, could alleviate this burden while enhancing tumor-fighting efficacy. Presented at the 2025 American Association for Cancer Research (AACR) annual meeting, the findings position Cantargia as a contender in a race to address a critical unmet need in oncology.

Breaking Down the Data: A Dual Benefit

Cantargia’s presentation highlighted results from three clinical trials, all demonstrating that higher doses of nadunolimab (1 mg/kg or greater) correlated with reduced CIPN incidence and delayed onset. The CANFOUR trial in advanced pancreatic cancer (PDAC) patients showed a 43% CIPN incidence at 1 mg/kg versus 100% at lower doses. In the CESTAFOUR trial, combining nadunolimab with FOLFOX chemotherapy in 14 patients across eight cancer types, the 1 mg/kg group saw a statistically significant delay in CIPN onset (p=0.0004) compared to lower doses. Similar trends emerged in the CAPAFOUR trial, where PDAC patients treated with escalating doses of nadunolimab alongside FOLFIRINOX also experienced reduced neuropathy.

These results are underscored by preclinical evidence showing that a mouse surrogate of nadunolimab mitigated neuropathy caused by taxanes, gemcitabine, and even antibody-drug conjugates (ADCs). The mechanism? Nadunolimab targets IL1RAP, a receptor for pro-inflammatory IL-1 family cytokines, which drive neuroinflammation—a key driver of CIPN. By blocking IL1RAP, the drug appears to protect nerves from chemotherapy’s toxic effects.

Clinical Efficacy Meets Quality of Life

The dual promise of nadunolimab—combating tumors while reducing CIPN—is critical in cancers like PDAC, where therapies like FOLFIRINOX are effective but notorious for severe side effects. In the CANFOUR trial, PDAC patients with high tumor IL1RAP expression achieved a 48% objective response rate (ORR) and a median overall survival (OS) of 14.2 months, with 35% surviving two years. These metrics are striking given PDAC’s historically grim prognosis: the five-year survival rate for metastatic cases is just 3%.

The combination of robust antitumor activity and reduced neuropathy could make nadunolimab a preferred treatment option, potentially extending therapy durations and improving adherence. This dual benefit addresses a key flaw in current oncology regimens, where side effects often limit efficacy.

Market Opportunity and Investment Implications

CIPN affects up to 60% of chemotherapy patients, with no approved therapies to date. The global neuropathic pain market, which includes treatments for CIPN, is projected to exceed $12 billion by 2030. Nadunolimab’s potential to address this unmet need positions Cantargia to capture a significant share, especially in indications like pancreatic, lung, or ovarian cancers where aggressive chemo/ADC regimens are standard.

Investors should also note Cantargia’s strategic focus. The company is advancing nadunolimab in combination with chemotherapy and ADCs, which are increasingly used in oncology but hampered by CIPN. If these trials replicate the AACR results, Cantargia could secure partnerships or accelerated approvals, particularly in indications like PDAC where survival gains are rare.

Risks and Considerations

While the data are compelling, Cantargia faces hurdles. Larger Phase III trials will be essential to validate the CIPN reduction and confirm tumor response durability. Additionally, competition is fierce: companies like Pfizer and Denovo Biopharma are developing CIPN therapies. Regulatory scrutiny of novel mechanisms like IL1RAP inhibition could also pose challenges.

Conclusion: A Strategic Bet on Dual Therapy

Cantargia’s presentation at AACR 2025 marks a pivotal moment. By targeting IL1RAP to mitigate CIPN while enhancing antitumor activity, nadunolimab could redefine standards of care in oncology. The 48% ORR and delayed CIPN in PDAC—where outcomes are otherwise dismal—suggest a compelling risk-reward profile for investors. If validated, these findings could propel Cantargia’s valuation, especially as the market for CIPN therapies grows.

For investors, Cantargia’s stock (CTRA) represents a high-risk, high-reward opportunity. With a current market cap of approximately $150 million and a robust pipeline anchored by nadunolimab, the company is well-positioned to capitalize on its breakthrough. However, sustained success hinges on Phase III outcomes and securing partnerships to commercialize the drug. For now, the data suggest a promising path forward—one that could alleviate suffering while extending survival for cancer patients.