Atezolizumab + Paclitaxel + Bevacizumab Triplet Hits 11-mo PFS in PD-L1-Negative First-Line TNBC

Atezolizumab (anti-PD-L1 mAb) combined with paclitaxel and bevacizumab (anti-VEGF) was tested in the single-arm phase 2 ATRACTIB study (NCT04408118) as first-line therapy for advanced triple-negative breast cancer regardless of PD-L1 status. Among 100 women (97.6% PD-L1-negative) the investigator-assessed median PFS reached 11.0 mo (95% CI 9.0–13.4) with an ORR of 63% and median OS of 27.4 mo; no treatment-related deaths or unexpected toxicities emerged. Historical controls show atezolizumab + nab-paclitaxel achieves 7.5 mo mPFS in an unselected ITT population and pembrolizumab + chemo delivers 9.7 mo but only in PD-L1 CPS %10 tumors, underscoring the absolute ~4–6 mo edge of this triplet in largely PD-L1-negative disease.