Key clinical point: Induction treatment with bevacizumab, etoposide, and cisplatin (BEEP) before whole-brain radiotherapy (WBRT) vs WBRT alone improved brain-specific progression-free survival (PFS) outcomes in patients with brain metastases from breast cancer (BMBC).
Major finding: Patients who received BEEP + WBRT vs WBRT alone had significantly longer median brain-specific PFS based on a predefined α level of ≤0.20 (8.1 vs 6.5 months; hazard ratio 0.71; P = .15) and higher 8-month brain-specific PFS rate (48.7% vs 26.3%; P = .03). Neutropenia, nausea, anemia, and leukopenia were the most common adverse events in the BEEP induction arm.
Study details: Findings are from the phase 2 A-PLUS trial that included 118 WBRT-naive patients with invasive breast cancer who had ≥1 metastatic brain tumors and were randomly assigned to receive BEEP induction followed by WBRT or only WBRT.
Disclosures: This study received investigational product support and grants funding from Roche Taiwan, Chugai Pharma Taiwan, and other sources. Four authors declared receiving personal fees, lecture fees, consulting or speakers’ bureau fees, travel support, or grants from Roche and other sources.
Source: Chen TW et al. Whole-brain radiotherapy alone vs preceded by bevacizumab, etoposide, and cisplatin for untreated brain metastases from breast cancer: A randomized clinical trial. JAMA Oncol. 2023 (Dec 21). doi: 10.1001/jamaoncol.2023.5456