Real-World Outcomes of First-Line Ribociclib Plus Aromatase Inhibitor in Patients With HR+/HER2− MBC

[Hazelgreen]

"Data from 160 patients at 17 sites was analysed. Median follow-up was 36.5 months." "A total of 63 of 160 (39%) patients remain on treatment." "A total of 17 of 160 (11%) discontinued treatment due to toxicity, with no treatment related deaths."

"A total of 56% of patients had at least 1 dose reduction, with neutropenia (68%) and abnormal liver enzymes (17%) the most common reasons."

"Median PFS (progression-free survival) was not reached, with PFS at 12 months and 18 months being 76% and 67%".

CONCLUSION: "The ribociclib and AI combination was well tolerated in this real-world setting." "The KARMA registry cohort achieved a superior PFS (>36.5 months) to MONALEESA-2, potentially due to more favourable baseline disease characteristics. Less frequent assessment scheduling in this non trial setting may also contribute."

"Compared to MONALEESA-2, patients were numerically younger (54.3 vs. 62 years), with higher rates of bone-only metastases (31% vs. 21%)." The PFS in MONALEESA-2 was 25.3 months.

[Mumberly]

I’m happy to hear that it’s working well for so many. sadly I was one of the 11% who had to discontinue due to toxicity.

I’m glad that, after 5 cycles, ibrance is agreeing with me ☺️

Kim

[Tantalon7211 in reply to Mumberly]

hello- I was wondering about your post- did you come off Ibrance due to toxicity - and then go back on lower dose that now works for you? I am on .75 Ibrance and an AI anastrozole - i believe I am starting my 5th cycle- but they are trying 21 days in and 14 days off due to low neutrophils and feeling unwell - it seems the last week of the cycle I get very fatigued and not well, so there are apparently different methods now- some are 2 weeks on and a week off - wondering if you felt any bad side effects to start and now your system is tolerating it- it seems the lower dose works as well for lots of us -

[Mumberly in reply to Tantalon7211]

I was initially on kisqali and letrozole but was pulled off kisqali after a couple of cycles because my ALT liver count went up to 285 (supposed to be less than 35) and then maxed out at 525 a couple of weeks after stopping the drug.

I also have issues with low neutrophils- when I was on chemo, on kisqali, and still now that I’m on ibrance. But always just on the cusp. But I don’t notice any side effects from it.

It took 5 months for my ALT to come back into range (only taking letro during this time) and then I started at 75mg of ibrance in September. 3 weeks on 1 week off.

My counts were good after that cycle so my oncologist bumped me up to 100mg and then after that cycle, I was bumped up to 125mg. Which I have have been on for 3 cycles now. I still have low neutrophils but they are at a consistent level so we’re carrying on. I get a small rash on the insides of my wrists for a few days in the 3rd week but other than that, I don’t have any side effects.

Not sure about energy level yet as I’m not back to work yet, so there’s not much competing for my time.

Scans have all shown improvement/stability so I’m thrilled with that. Bloodwork is monthly at this point but I hope to move to every three months after my blood draw next Monday 🤞🏻

Kim

[Hazelgreen in reply to Tantalon7211]

Please also check out the alternate schedule for Ibrance of 5 days on and 2 days off (see Dragonfly2 's posts).

[mariootsi in reply to Mumberly]

Happy for you Kim