fulvestrant + ribociclib + spartalizumab

This is a combination therapy consisting of fulvestrant (an estrogen receptor antagonist), ribociclib (a CDK4/6 inhibitor), and spartalizumab (a PD-1 inhibitor). The combination was investigated in a phase I clinical trial for patients with hormone receptor (HR)-positive/HER2-negative metastatic breast cancer. The therapy showed limited efficacy with only two confirmed partial responses (13.3%) observed. However, the combination demonstrated elevated hepatotoxicity, with grade 3-4 hypertransaminasemia occurring in 46.7% (AST) and 40.0% (ALT) of patients, which ultimately precluded further development of this specific combination.