Breast Cancer Treatment Gives Hope for Younger Women with Advanced Disease

June 13, 2019

Clinical Contributors to this Story

Deena M. Atieh Graham, M.D. contributes to topics such as Hematology, Medical Oncology.

Michael J. Levitt, M.D. contributes to topics such as Internal Medicine, Hematology, Medical Oncology.

A recent trial found that the drug, ribociclib (brand name Kisqali), improved survival among younger patients with advanced forms of breast cancer.

Doctors have been using the drug successfully for a couple of years. The recent study offers exciting confirmatory data that ribociclib increases the effectiveness of hormonal therapy and can extend the lifespan of younger women with breast cancer, notes Deena M. Atieh Graham, M.D., a medical oncologist who specializes in breast and gynecologic cancers.

“Once we see a survival benefit, that is the most compelling evidence that a drug is helpful for patients,” Dr. Graham says.

Study Shows Women Live Longer

The study on the recent trial of ribociclib was presented at the American Society of Clinical Oncology’s annual meeting. The risk of death was cut by nearly one-third compared to women who only received hormone therapy, the researchers found.

The trial, led by a team at the University of California in Los Angeles, followed 672 pre-menopausal women under the age of 59. They all had advanced hormone receptor-positive, HER2-negative, breast cancer.

The patients took either ribociclib or a placebo. All the women also received anti-hormonal or endocrine hormone therapy, which consists of tamoxifen or a nonsteroidal aromatase inhibitor (NSAI), as well as goserelin, a medication that shuts down estrogen production in the ovaries.

Results after 42 months:

  • 70% of those treated with the combination therapy were still alive
  • 46% of those treated with a placebo (those who received only hormone therapy) were still alive
  • Women who received ribociclib lived an average of 23.8 months without disease progression
  • Women treated with a placebo (those who received only hormone therapy) lived an average of 13 months without disease progression

The research marks the first time that a statistically significant improvement in survival has been observed with a drug of this type that was used along with endocrine therapy in patients with HR+/HER2- advanced breast cancer.

Along with the presentation at the conference, the results of the trial will be published in the New England Journal of Medicine.

What’s Next for Ribociclib?

Ribociclib is a drug known as a CDK4/6 inhibitor. It blocks two proteins that help cancer cells grow and divide. Two other newer drugs in its class are Verzenio (abemaciclib) and Ibrance (palbociclib).

“These drugs [CDK4/6 inhibitors] in general are very effective and well tolerated. They have changed the landscape of breast cancer treatment for patients with certain forms of breast cancer,” explains hematologist/oncologist, Michael J. Levitt, M.D..

Dr. Levitt has been using these drugs in his practice for the past four years to treat women with advanced breast cancer. “When compared to the others drugs in its class, ribociclib requires additional blood and cardiac monitoring after being administered.”

“As a result of the study, I will definitely consider prescribing ribociclib in younger patients,” Dr. Levitt says. “Women are living longer, thanks to better treatments.”

Breast Cancer on the Rise

Advanced breast cancer is not as common in premenopausal women as it is in older women, however the incidence of advanced breast cancer in younger women is increasing.

In the United States, the occurrence of advanced breast cancer in women aged 20 to 39 increased 2 percent each year between 1978 and 2008, according to a report in JAMA.

Provider Bios:

Deena M. Atieh Graham, M.D., is a hematologist/oncologist at John Theurer Cancer Center at Hackensack University Medical Center and practices in Hackensack, NJ. To make an appointment, call 551-996-5900.

Michael J. Levitt, M.D, FACP, HMDC., is a hematologist/oncologist with Hackensack Meridian Health Cancer Care and practices in Brick, and Neptune, NJ. To make an appointment, call 732-528-0760.

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