Ribociclib plus fulvestrant for advanced breast cancer: Health-related quality-of-life analyses from the MONALEESA-3 study

Ribociclib plus fulvestrant for advanced breast cancer: Health-related quality-of-life analyses from the MONALEESA-3 study

Fasching et al. The Breast 54 (2020) 148-154 (2020) • DOI: 10.1016/j.breast.2020.09.008

Key Finding: Ribociclib + Fulvestrant maintains Health-Related Quality of Life (HRQoL) while delaying deterioration compared to Placebo.
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Study Design & Arms
Ribociclib plus fulvestrant (n=484)Placebo plus fulvestrant (n=242)Baseline QoLCycles 3, 5, 7...End of Treatment
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Baseline Scores (Mean ± SD)
Comparing baseline Global Health Status and Pain scores between arms. Higher Global Health is better; Lower Pain is better.
Baseline Global Health Status/QOL ScoreBaseline Pain Score (EORTC QLQ-C30)020406080100Ribociclib plus fulvestrantPlacebo plus fulvestrant
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Time to Deterioration (Hazard Ratios)
Hazard Ratio (HR) < 1.0 indicates Ribociclib delays deterioration compared to Placebo.
0.500.550.600.650.700.750.800.850.900.951.001.051.101.151.20Global Health StatusPhysical FunctioningEmotional FunctioningFatiguePain (EORTC QLQ-C30)BPI-SF Pain Severity IndexNo Difference (HR=1)Favors Ribociclib0.810.820.760.911.060.77
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Median Time to Deterioration (Months)
Global Health StatusPhysical FunctioningEmotional FunctioningFatiguePainBPI-SF Pain Severity Index01020304050
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Pain Reduction at 8 Weeks
Change from baseline in EORTC QLQ-C30 pain scores. Negative values indicate improvement (reduction in pain).
−5.0−4.5−4.0−3.5−3.0−2.5−2.0−1.5−1.0−0.50.0Ribociclib plus fulvestrantPlacebo plus fulvestrant-4.0-3.6
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Primary QoL Outcome: Global Health Status
HR = 0.81Favors TxFavors Pbo

Metric: Time to definitive deterioration (TTD) ≥10% in Global Health Status

Result: Hazard Ratio 0.81 (Favors Ribociclib)

Interpretation: Patients on Ribociclib + Fulvestrant maintained their global health status longer than those on Placebo (Median 35.9 vs 33.1 months).

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Appendix: Raw Data & Provenance
Metric Group Value Source
Baseline Global Health Status/QOL Score Ribociclib plus fulvestrant 65.5 (19.1) Table 1 (p2)
Baseline Global Health Status/QOL Score Placebo plus fulvestrant 68.4 (18.5) Table 1 (p2)
Baseline Pain Score (EORTC QLQ-C30) Ribociclib plus fulvestrant 30.0 (25.5) Table 1 (p2)
Baseline Pain Score (EORTC QLQ-C30) Placebo plus fulvestrant 27.8 (25.9) Table 1 (p2)
Time to definitive deterioration (TTD) ≥10% in Global Health Status Ribociclib plus fulvestrant 35.9 (HR 0.81) Figure 2a (p4)
Time to definitive deterioration (TTD) ≥10% in Global Health Status Placebo plus fulvestrant 33.1 Figure 2a (p4)
Time to definitive deterioration (TTD) ≥10% in Physical Functioning Ribociclib plus fulvestrant 38.7 (HR 0.82) Results Section 3.3 (p3)
Time to definitive deterioration (TTD) ≥10% in Physical Functioning Placebo plus fulvestrant 34.9 Results Section 3.3 (p3)
Time to definitive deterioration (TTD) ≥10% in Emotional Functioning Ribociclib plus fulvestrant 38.6 (HR 0.76) Results Section 3.3 (p3)
Time to definitive deterioration (TTD) ≥10% in Emotional Functioning Placebo plus fulvestrant 30.4 Results Section 3.3 (p3)
Time to definitive deterioration (TTD) ≥10% in Fatigue Ribociclib plus fulvestrant 38.7 (HR 0.91) Results Section 3.3 / 3.4 (p5)
Time to definitive deterioration (TTD) ≥10% in Fatigue Placebo plus fulvestrant 36.0 Results Section 3.3 / 3.4 (p5)
Time to definitive deterioration (TTD) ≥10% in Pain (EORTC QLQ-C30) Ribociclib plus fulvestrant 41.9 (HR 1.06) Results Section 3.3 / 3.4 (p5)
Time to definitive deterioration (TTD) ≥10% in Pain (EORTC QLQ-C30) Placebo plus fulvestrant not estimable Results Section 3.3 / 3.4 (p5)
Time to definitive deterioration (TTD) ≥10% in BPI-SF Pain Severity Index Ribociclib plus fulvestrant 42.7 (HR 0.77) Figure 5 (p6)
Time to definitive deterioration (TTD) ≥10% in BPI-SF Pain Severity Index Placebo plus fulvestrant 35.9 Figure 5 (p6)
Change from baseline in EORTC QLQ-C30 pain scores at 8 weeks Ribociclib plus fulvestrant -4.0 Results Section 3.3 / 3.4 (p5)
Change from baseline in EORTC QLQ-C30 pain scores at 8 weeks Placebo plus fulvestrant -3.6 Results Section 3.3 / 3.4 (p5)
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