Theme


MONALEESA-2: Final Overall Survival

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. Data derived from the MONALEESA-2 Clinical Trial (NCT01958021).

First-Line Ribociclib + Letrozole extends median overall survival beyond 5 years in postmenopausal HR+/HER2- Advanced Breast Cancer.

Population (N)
668
Postmenopausal HR+/HER2-
Follow-Up
80 mo
Median Duration
Study Design
Phase 3
RCT, Placebo-Controlled

Median Overall Survival

63.9 Months
Ribociclib Arm

+12.5 Month absolute survival gain vs. Placebo (51.4 mo).

Risk Reduction

24% Relative Reduction
in Risk of Death
Hazard Ratio: 0.76 (95% CI, 0.63–0.93)
P=0.008

Time to Chemotherapy

Delayed need for subsequent chemotherapy by nearly 1 year (11.7 months).

HR 0.74 (95% CI, 0.61–0.91)

Recommendation: Standard of Care

With the longest reported median overall survival in this setting, Ribociclib + Letrozole is a preferred first-line treatment for postmenopausal patients with HR+/HER2- advanced breast cancer.

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; NE, could not be estimated; PgR, progesterone receptor.
Bibliography8
  1. 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)
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. National Comprehensive Cancer Network. Metastatic breast cancer. 2020. (link)
  7. 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 that progressed on endocrine therapy — MONARCH 2: a randomized clinical trial. JAMA Oncol 2020; 6:116-24.
  8. 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.