ASCO 2026 | A-BRAVE: time-of-day immunotherapy administration in early-stage TNBC

A-BRAVE, as we all know, was an adjuvant trial that randomized patients with early triple-negative breast cancer who have completed neoadjuvant chemotherapy or adjuvant chemotherapy to avelumab or to the control arm. So today, at this ASCO, we saw the results from the exploratory analysis of A-BRAVE, looking at the question of timing of day of avelumab infusion with efficacy. And we found that there was no difference in distant disease-free survival or overall survival based on the timing of day of avelumab. Additionally, the investigators also looked at immune analysis, and they found that higher baseline levels and PD-L1 positivity was associated with higher benefit with morning administration with avelumab. And in immune cold tumors, the afternoon infusion of avelumab was superior, which seemed to be counterintuitive. The authors, however, one of the reasons for this could be that avelumab has a long infusion time, a long half-life. Avelumab has a long half-life. And it’s unclear why the authors only looked at the first four doses. The second question is that there remains uncertainty about how to define morning versus afternoon infusion. And the finding of immune cold tumors preferentially benefiting from afternoon infusion of avelumab could potentially, one of the reasons could be the biopsy timing or could be patient chronotype, which could be some of the factors that the investigators could potentially consider looking into to explain these unexpected findings why the immune cold tumors benefited from afternoon dosing.

This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.