First-line ribociclib and endocrine therapy may be more effective than combined chemotherapy in aggressive breast cancer (“Significantly” better)

Medical Xpress / American Association for Cancer Research / 2022 San Antonio Breast Cancer Symposium ^ | Dec. 6, 2022 | Yen-Shen Lu, MD, Ph.D. et al

[ConservativeMind]

In patients with hormone receptor-positive, HER2-negative, advanced breast cancer—including patients with visceral crises—those treated with ribociclib plus endocrine therapy had fewer adverse events and a significantly longer progression-free survival compared to those treated with combination chemotherapy, according to results from the phase II RIGHT Choice trial. Visceral crisis is defined as the presence of metastases that compromise the function of vital organs.

"These findings suggest that through the use of first-line ribociclib plus endocrine therapy, we may be able to avoid or delay chemotherapy and spare patients the toxicities and discontinuations associated with chemotherapy," said Yen-Shen Lu, MD, Ph.D.

Lu and colleagues designed the phase II RIGHT Choice clinical trial to compare the outcomes of patients with aggressive disease treated with ribociclib plus ET to those treated with combination chemotherapy. They recruited 222 premenopausal or perimenopausal patients with hormone receptor-positive, HER2-negative, aggressive breast cancer, more than 50 percent of whom had visceral crises, as determined by the investigators; 112 were randomly assigned to receive ribociclib plus an aromatase inhibitor—letrozole or anastrozole—and goserelin, which decreases ovarian estrogen production. The other 110 patients were assigned to receive a physicians'-choice combination chemotherapy regimen.

Patients treated with ribociclib plus ET had a progression-free survival of 24 months, nearly one year more than that of patients treated with chemotherapy (12.3 months). The median time to treatment failure was also longer among patients treated with ribociclib plus ET—18.6 months versus 8.5 months among patients treated with chemotherapy.

The overall response rate was similar between the two treatment arms (65.2 percent for ribociclib plus ET and 60 percent for chemotherapy). However, the rates of symptomatic adverse events, such as diarrhea and fatigue, were different: Serious, treatment-related adverse events emerged in 1.8 percent of patients receiving ribociclib plus ET and in 8 percent of patients receiving combination chemotherapy.

[ConservativeMind]

A less toxic therapy with greater benefit is always helpful.

[ConservativeMind]

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[thinden]

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[MayflowerMadam]

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