Safety and efficacy of ribociclib plus letrozole in patients with HR+, HER2- advanced breast cancer: Results from the Spanish sub-population of the phase 3b CompLEEment-1 trial

Breast. 2022 Dec:66:77-84. doi: 10.1016/j.breast.2022.09.006. Epub 2022 Sep 28.

Abstract

Background: Breast cancer is the most common malignancy and the second leading cause of cancer-related mortality in Spanish women. Ribociclib in combination with endocrine therapy (ET) has shown superiority in prolonging survival in patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) vs. ET alone.

Methods: CompLEEment-1 is a single-arm, open-label phase 3b trial evaluating ribociclib plus letrozole in a broad population of patients with HR+, HER2- ABC. The primary endpoints were safety and tolerability. Here we report data for Spanish patients enrolled in CompLEEment-1.

Results: A total of 526 patients were evaluated (median follow-up: 26.97 months). Baseline characteristics showed a diverse population with a median age of 54 years. At study entry, 56.5% of patients had visceral metastases and 8.7% had received prior chemotherapy for advanced disease. Rates of all-grade and Grade ≥3 adverse events (AEs) were 99.0% and 76.2%, respectively; 21.3% of patients experienced a serious AE, and 15.8% of AEs led to treatment discontinuation. AEs of special interest of neutropenia, increased alanine aminotransferase, increased aspartate aminotransferase and QTcF prolongation occurred in 77.8%, 14.8%, 11.4% and 4.0% of patients, respectively. Patients aged >70 years experienced increased rates of all-grade and Grade ≥3 neutropenia and anemia. Efficacy results were consistent with the global study.

Conclusions: Results from Spanish patients enrolled in CompLEEment-1 are consistent with global data showing efficacy and a manageable safety profile for ribociclib plus letrozole treatment in patients with HR+, HER2- ABC, including populations of interest (NCT02941926).

Trial registration: ClinicalTrials.gov NCT02941926.

Keywords: Advanced breast cancer; CDK4/6 inhibitor; Postmenopausal; Premenopausal; Ribociclib.

Publication types

  • Clinical Trial, Phase III

MeSH terms

  • Aminopyridines / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Aromatase Inhibitors / therapeutic use
  • Breast Neoplasms* / pathology
  • Female
  • Humans
  • Letrozole
  • Middle Aged
  • Neutropenia* / etiology
  • Protein Kinase Inhibitors / therapeutic use
  • Receptor, ErbB-2 / metabolism

Substances

  • Letrozole
  • ribociclib
  • Receptor, ErbB-2
  • Aminopyridines
  • Aromatase Inhibitors
  • Protein Kinase Inhibitors

Associated data

  • ClinicalTrials.gov/NCT02941926