TY - JOUR
T1 - Efficacy and Safety of Ribociclib With Letrozole in US Patients Enrolled in the MONALEESA-2 Study
AU - Yardley, Denise A.
AU - Hart, Lowell
AU - Favret, Anne
AU - Blau, S.
AU - Diab, Sami
AU - Richards, Donald
AU - Sparano, Joseph
AU - Beck, J. Thad
AU - Richards, Paul
AU - Ward, Patrick
AU - Ramaswamy, Bhuvaneswari
AU - Tsai, Michaela
AU - Blackwell, Kimberly
AU - Pluard, Timothy
AU - Tolaney, Sara M.
AU - Esteva, Francisco J.
AU - Truica, Cristina I.
AU - Alemany, Carlos
AU - Volas-Redd, Gena
AU - Shtivelband, Mikhail
AU - Purkayastha, Das
AU - Dalal, Anand A.
AU - Miller, Michelle
AU - Hortobagyi, Gabriel N.
N1 - Publisher Copyright:
© 2019
PY - 2019/8
Y1 - 2019/8
N2 - Background: In the Mammary Oncology Assessment of LEE011’s (Ribociclib's) Efficacy and Safety (MONALEESA-2) study, combination treatment with the selective inhibitor of cyclin-dependent kinases 4/6 ribociclib with letrozole significantly improved progression-free survival (PFS) versus letrozole alone in postmenopausal women with hormone receptor-positive HR+/HER2− advanced breast cancer (ABC). Herein we present results from the subset of US patients enrolled in MONALEESA-2. Patients and Methods: Postmenopausal women with HR+/HER2− ABC without previous treatment for advanced disease were randomized (1:1) to ribociclib 600 mg/d (3 weeks on/1 week off) with letrozole 2.5 mg/d (continuous) or placebo with letrozole. The primary end point was locally assessed PFS. Results: Overall, 213 US patients were enrolled in MONALEESA-2 (ribociclib, n = 100; placebo, n = 113). Baseline characteristics were similar between treatment groups and consistent with the global population. With a median follow-up of 27 months, 38 (38%) and 29 (26%) patients in the ribociclib and placebo groups, respectively, had continued to receive treatment. Median PFS was 27.6 months with ribociclib and 15.0 months with placebo (hazard ratio, 0.53). The most common all-cause adverse events were neutropenia (ribociclib, 72.0% [n = 72]; placebo, 4.6% [n = 5]), nausea (ribociclib, 69.0% [n = 69]; placebo, 44.0% [n = 48]), and fatigue (ribociclib, 60.0% [n = 60]; placebo, 50.5% [n = 55]). Two patients (ribociclib, 2.0%; placebo, 0%) experienced febrile neutropenia. Conclusion: In the US subset of MONALEESA-2, ribociclib with letrozole showed superior efficacy versus letrozole alone. These findings are consistent with the global population and support first-line use of ribociclib with letrozole in patients with HR+/HER2− ABC. Endocrine therapy is standard care for postmenopausal women with hormone receptor-positive (HR+)/HER2− advanced breast cancer (ABC). A Mammary Oncology Assessment of LEE011’s (Ribociclib's) Efficacy and Safety (MONALEESA-2) study subset of postmenopausal women with HR+/HER2− ABC without previous treatment for advanced disease were randomized to ribociclib/letrozole or placebo/letrozole. Improved progression-free survival was observed in patients treated with first-line ribociclib/letrozole versus placebo/letrozole, consistent with the global population. These results suggest ribociclib/letrozole is safe and effective in this patient population.
AB - Background: In the Mammary Oncology Assessment of LEE011’s (Ribociclib's) Efficacy and Safety (MONALEESA-2) study, combination treatment with the selective inhibitor of cyclin-dependent kinases 4/6 ribociclib with letrozole significantly improved progression-free survival (PFS) versus letrozole alone in postmenopausal women with hormone receptor-positive HR+/HER2− advanced breast cancer (ABC). Herein we present results from the subset of US patients enrolled in MONALEESA-2. Patients and Methods: Postmenopausal women with HR+/HER2− ABC without previous treatment for advanced disease were randomized (1:1) to ribociclib 600 mg/d (3 weeks on/1 week off) with letrozole 2.5 mg/d (continuous) or placebo with letrozole. The primary end point was locally assessed PFS. Results: Overall, 213 US patients were enrolled in MONALEESA-2 (ribociclib, n = 100; placebo, n = 113). Baseline characteristics were similar between treatment groups and consistent with the global population. With a median follow-up of 27 months, 38 (38%) and 29 (26%) patients in the ribociclib and placebo groups, respectively, had continued to receive treatment. Median PFS was 27.6 months with ribociclib and 15.0 months with placebo (hazard ratio, 0.53). The most common all-cause adverse events were neutropenia (ribociclib, 72.0% [n = 72]; placebo, 4.6% [n = 5]), nausea (ribociclib, 69.0% [n = 69]; placebo, 44.0% [n = 48]), and fatigue (ribociclib, 60.0% [n = 60]; placebo, 50.5% [n = 55]). Two patients (ribociclib, 2.0%; placebo, 0%) experienced febrile neutropenia. Conclusion: In the US subset of MONALEESA-2, ribociclib with letrozole showed superior efficacy versus letrozole alone. These findings are consistent with the global population and support first-line use of ribociclib with letrozole in patients with HR+/HER2− ABC. Endocrine therapy is standard care for postmenopausal women with hormone receptor-positive (HR+)/HER2− advanced breast cancer (ABC). A Mammary Oncology Assessment of LEE011’s (Ribociclib's) Efficacy and Safety (MONALEESA-2) study subset of postmenopausal women with HR+/HER2− ABC without previous treatment for advanced disease were randomized to ribociclib/letrozole or placebo/letrozole. Improved progression-free survival was observed in patients treated with first-line ribociclib/letrozole versus placebo/letrozole, consistent with the global population. These results suggest ribociclib/letrozole is safe and effective in this patient population.
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U2 - 10.1016/j.clbc.2019.02.007
DO - 10.1016/j.clbc.2019.02.007
M3 - Article
C2 - 31160171
AN - SCOPUS:85066308000
SN - 1526-8209
VL - 19
SP - 268-277.e1
JO - Clinical Breast Cancer
JF - Clinical Breast Cancer
IS - 4
ER -