There is limited clinical evidence comparing different chemotherapy-based combination therapies. This study aimed to evaluate and compare the efficacy and safety of chemotherapy combined with immunotherapy versus chemotherapy combined with anti-angiogenic therapy in the treatment of metastatic triple-negative breast cancer (TNBC). This study included patients with metastatic TNBC who received either anti-PD-1 monoclonal antibody or bevacizumab in combination with chemotherapy. The primary endpoint was progression-free survival (PFS); the secondary endpoints included overall response rate (ORR), clinical benefit rate (CBR), and safety. Between October 2018 and June 2024, 130 eligible patients were enrolled. Of these, 60 patients received chemotherapy combined with anti-PD-1 monoclonal antibody, and 70 patients received chemotherapy combined with bevacizumab. The median PFS was 5.9 months (95% CI: 4.3-8.7) in the immunotherapy group, compared to 3.0 months (95% CI: 2.2-4.7) in the bevacizumab group (hazard ratio HR = 0.42, 95% confidence interval CI 0.28-0.62, p < 0.0001). The ORR rates were 55% in the immunotherapy group and 27.1% in the bevacizumab group (p = 0.001). The CBR rates were 43.3% and 22.9%, respectively (p = 0.013). The overall incidence of adverse events was comparable between the two groups. In the treatment of metastatic TNBC, chemotherapy combined with immunotherapy offers significant survival advantages over chemotherapy combined with bevacizumab.
Wang et al. (Mon,) studied this question.