Theme
MONALEESA-2
Source
Source: Hortobagyi GN, Stemmer SM, Burris HA, et al. Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. N Engl J Med. 2022;386:942-50. (MONALEESA-2; NCT01958021).
First-Line Ribociclib Breaks the 5-Year Survival Barrier
Study Design
Phase 3, Randomized, Double-blind, Placebo-controlled.
Population
N=668 Postmenopausal women. HR+/HER2- Advanced Breast Cancer.
Follow-Up
Long-term analysis. Median: 6.6 years (80 months).
Median Overall Survival (OS)
63.9 Mos
Ribociclib + Letrozole
+12.5 Months improvement vs. Placebo (51.4 mos).
Longest reported survival in this setting.
Survival Benefit
HR: 0.76
24%
Relative Reduction in Risk of Death
(P=0.008)
6-Year Survival Rate
Time to Chemo
50.6 Mos
Ribociclib Arm
38.9 Mos
Placebo Arm
Significant delay in need for cytotoxic treatment.
Clinical Recommendation
Adopt Ribociclib + Letrozole as a standard-of-care first-line regimen. This combination demonstrates a fundamental extension of life expectancy beyond 5 years with a manageable safety profile, fulfilling the primary goal of advanced cancer therapy.
AbbreviationsQuick
CDK4/6, cyclin-dependent kinases 4 and 6; CI, confidence interval; ECOG, Eastern Cooperative Oncology Group; ER, estrogen receptor; HER2, human epidermal growth factor receptor 2; HR, hormone receptor; PgR, progesterone receptor.
Bibliography8
- Hortobagyi GN, Stemmer SM, Burris HA, et al. Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. N Engl J Med 2022;386:942-50. (DOI: 10.1056/NEJMoa2114663)
- Hortobagyi GN, Stemmer SM, Burris HA, et al. Ribociclib as first-line therapy for HR-positive, advanced breast cancer. N Engl J Med 2016;375:1738-48.
- Im S-A, Lu Y-S, Bardia A, et al. Overall survival with ribociclib plus endocrine therapy in breast cancer. N Engl J Med 2019; 381: 307-16.
- Slamon DJ, Neven P, Chia S, et al. Overall survival with ribociclib plus fulvestrant in advanced breast cancer. N Engl J Med 2020; 382: 514-24.
- Sledge GW Jr, Toi M, Neven P, et al. The effect of abemaciclib plus fulvestrant on overall survival in hormone receptor-positive, ERBB2-negative breast cancer... JAMA Oncol 2020; 6:116-24.
- Goetz MP, Toi M, Campone M, et al. MONARCH 3: abemaciclib as initial therapy for advanced breast cancer. J Clin Oncol 2017;35:3638-46.
- Cristofanilli M, Turner NC, Bondarenko I, et al. Fulvestrant plus palbociclib versus fulvestrant plus placebo... Lancet Oncol 2016; 17:425-39.
- Cardoso F, Paluch-Shimon S, Senkus E, et al. 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol 2020;31:1623-49.
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