In a Chinese phase II study (ABC) reported in the Journal of Clinical Oncology, Li et al found that the combination of the PD-L1 inhibitor adebrelimab, bevacizumab, and cisplatin or carboplatin showed high intracranial activity and progression-free survival in patients with triple-negative breast cancer with active brain metastases.
Study Details
In the trial, 35 patients enrolled at Fudan University Shanghai Cancer Center between July 2020 and October 2024 received adebrelimab at 20 mg/kg, bevacizumab at 7.5 mg/kg, and cisplatin at 75 mg/m2 (n = 30) or carboplatin AUC = 5 (n = 5) on day 1 in 3-week cycles. Patients had received a median of 2 prior treatments (range = 0–4) for metastatic disease. The primary outcome measure was central nervous system (CNS) objective response rate.
Key Findings
Confirmed CNS objective response was observed in 27 (77.1%, 95% confidence interval [CI] = 59.9%–89.6%) of 35 patients, with complete response in 5.
Among secondary outcome measures, the CNS clinical benefit rate was 80.0% (95% CI = 63.1%–91.6%). Median overall progression-free survival was 8.3 months (95% CI = 5.8–11.5 months). Median CNS progression-free survival was 10.3 months (95% CI = 7.4–14.3 months). Median overall survival was 21.1 months (95% CI = 13.2 months to not reached).
Among the 28 patients with progression, it was intracranial-only in 9 patients (32.1%), extracranial-only in 10 (35.7%), and both in 9 (32.1%).
The most common treatment-related adverse events of any grade were anemia (80.0%), hypomagnesemia (74.3%), neutropenia (71.4%), and asthenia (62.9%). Grade ≥ 3 treatment-related adverse events occurred in 65.7% of patients, most commonly thrombocytopenia (11.4%) and neutropenia, peripheral sensory neuropathy, and hypertension (8.6% each). No treatment-related deaths were observed.
The investigators concluded: “The combination of adebrelimab, bevacizumab, and cisplatin/carboplatin was the first regimen to demonstrate promising intracranial antitumor activity and prolonged [progression-free survival] and CNS [progression-free survival], along with a manageable safety profile, warranting further investigation.”
Jian Zhang, PhD, of the Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China, is the corresponding author for the Journal of Clinical Oncology article.
DISCLOSURE: The study was supported by the National Natural Science Foundation of China, Shanghai Science and Technology Innovation Action Plan, and Jiangsu Hengrui Pharmaceuticals. For full disclosures of the study authors, visit ascopubs.org.
