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Ribociclib as First-Line Therapy for HR-Positive, Advanced Breast Cancer
Open accessAbstract
BACKGROUND: The inhibition of cyclin-dependent kinases 4 and 6 (CDK4/6) could potentially overcome or delay resistance to endocrine therapy in advanced breast cancer that is positive for hormone receptor (HR) and negative for human epidermal growth factor receptor 2 (HER2). METHODS: . RESULTS: for superiority). The median duration of follow-up was 15.3 months. After 18 months, the progression-free survival rate was 63.0% (95% confidence interval [CI], 54.6 to 70.3) in the ribociclib group and 42.2% (95% CI, 34.8 to 49.5) in the placebo group. In patients with measurable disease at baseline, the overall response rate was 52.7% and 37.1%, respectively (P<0.001). Common grade 3 or 4 adverse events that were reported in more than 10% of the patients in either group were neutropenia (59.3% in the ribociclib group vs. 0.9% in the placebo group) and leukopenia (21.0% vs. 0.6%); the rates of discontinuation because of adverse events were 7.5% and 2.1%, respectively. CONCLUSIONS: Among patients receiving initial systemic treatment for HR-positive, HER2-negative advanced breast cancer, the duration of progression-free survival was significantly longer among those receiving ribociclib plus letrozole than among those receiving placebo plus letrozole, with a higher rate of myelosuppression in the ribociclib group. (Funded by Novartis Pharmaceuticals; ClinicalTrials.gov number, NCT01958021 .).
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In the citing paper
“The last 2 years have seen the establishment of cyclin-dependent kinase (CDK)4/6 inhibitors combined with endocrine therapy (ET) as the standard of care for ER-positive/HER2-negative ABC”
From 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) (2020) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“substantial PFS benefit and good toxicity profile.36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57”
From 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) (2020) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“These agents can be combined with an aromatase inhibitor (AI) or fulvestrant, and are effective in de novo or recurrent ABC, in first or second line, in cases of primary or secondary resistance, in postmenopausal and premenopausal women (the latter with ovarian function suppression/ablation), and in men (preferably with a luteinising hormone-releasing hormone agonist).”
From 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) (2020) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The median duration of exposure to trial treatment in the ribociclib group was 20.2 months (interquartile range, 7.4 to 45.1), which is 7 months longer than it was at the time of the primary analysis of progression-free survival. 10”
From Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. (2022) · cites this paper as [10]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In the primary and updated analyses of MONALEESA-2, progression-free survival was significantly longer with ribociclib plus letrozole than with placebo plus letrozole (median in updated analysis, 25.3 months vs. 16.0 months; hazard ratio for disease progression or death, 0.57; 95% confidence interval [CI], 0.46 to 0.70; P<0.001).”
From Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. (2022) · cites this paper as [10]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Data for overall survival were immature at the time of the primary and updated analyses.”
From Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. (2022) · cites this paper as [10]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In the primary and updated analyses of MONALEESA-2, progression-free survival was significantly longer with ribociclib plus letrozole than with placebo plus letrozole (median in updated analysis, 25.3 months vs. 16.0 months; hazard ratio for disease progression or death, 0.57; 95% confidence interval [CI], 0.46 to 0.70; P<0.001).”
From Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. (2022) · cites this paper as [10]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The use of CDK4/6 inhibitors (ribociclib, abemaciclib, and palbociclib) improved progression-free survival in this patient population, leading to regulatory approvals. 9-13”
From Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. (2022) · cites this paper as [10]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“In a previous analysis of this phase 3 trial, first-line ribociclib plus letrozole resulted in significantly longer progression-free survival than letrozole alone among postmenopausal patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer.”
From Overall Survival with Ribociclib plus Letrozole in Advanced Breast Cancer. (2022) · cites this paper as [10]
In the citing paper
“However, 10% of the patients treated with abemaciclib develop grade 3 diarrhea, which is very rare with the other two inhibitors (Asghar et al., 2015; Hortobagyi et al., 2016).”
From CDK4/6 Inhibitors: The Mechanism of Action May Not Be as Simple as Once Thought (2018) · cites this paper as Hortobagyi et al., 2016
In the citing paper
“Abemaciclib appears to be better tolerated overall, with only 55% of patients experiencing significant adverse events (as compared to 70–80% with ribociclib and palbociclib) and only 21% with grade 3–4 neutropenia.”
From CDK4/6 Inhibitors: The Mechanism of Action May Not Be as Simple as Once Thought (2018) · cites this paper as Hortobagyi et al., 2016
In the citing paper
“Grade 3–4 neutropenia is observed in approximately 60% of patients taking palbociclib and ribociclib (Asghar et al., 2015; Hortobagyi et al., 2016).”
From CDK4/6 Inhibitors: The Mechanism of Action May Not Be as Simple as Once Thought (2018) · cites this paper as Hortobagyi et al., 2016
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Aberrant FGFR signaling mediates resistance to CDK4/6 inhibitors in ER+ breast cancer
Formisano, L., Lu, Y., Servetto, A., Hanker, A. B., Jansen, V. M., Bauer, J. A., Sudhan, D. R., Zotano, Á. G., Croessmann, S., Guo, Y. P., et al. (2019) · Nature Communications · doi:10.1038/s41467-019-09068-2 · Cited by 416
Self-citationRecent Advances in the Treatment of Breast Cancer
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“They were shown to significantly improve median PFS by 10 months (16) and PFS rate by 20% after 18 months (17), respectively, compared to letrozole alone.”
BackgroundCDK4/6 Inhibitors: The Mechanism of Action May Not Be as Simple as Once Thought
Klein, M. E., Kovatcheva, M., Davis, L. E., Tap, W. D., & Koff, A. (2018) · Cancer Cell · doi:10.1016/j.ccell.2018.03.023 · Cited by 378
“However, 10% of the patients treated with abemaciclib develop grade 3 diarrhea, which is very rare with the other two inhibitors (Asghar et al., 2015; Hortobagyi et al., 2016).”
BackgroundCyclin-dependent protein serine/threonine kinase inhibitors as anticancer drugs
Roskoski, R. J. (2018) · Pharmacological Research · doi:10.1016/j.phrs.2018.11.035 · Cited by 412
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Mutational Profile of Metastatic Breast Cancers: A Retrospective Analysis
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“However, recent studies on first-line therapies for advanced breast cancer have shown that early death is limited [32,33], and it is therefore unlikely that it has dramatically impacted the analysis.”
BackgroundSelf-citationFrom state-of-the-art treatments to novel therapies for advanced-stage pancreatic cancer
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Rugo, H. S., Delord, J., Im, S., Ott, P. A., Piha-Paul, S. A., Bedard, P. L., Sachdev, J. C., Tourneau, C. L., van Brummelen, E. M. J., Varga, A., et al. (2018) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-17-3452 · Cited by 381
“Since the time this study was conducted, CDK4/6 inhibitors have emerged as first- and second-line treatments for ERþ/HER2– metastatic breast cancer (6, 9).”
BackgroundMolecular mechanisms of resistance to CDK4/6 inhibitors in breast cancer: A review
Pandey, K., An, H. J., Kim, S., Lee, S. A., Kim, S., Lim, S. M., Kim, G. M., Sohn, J., & Moon, Y. W. (2018) · International Journal of Cancer · doi:10.1002/ijc.32020 · Cited by 376
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Self-citationCell-Cycle Therapeutics Come of Age
Ingham, M. A., & Schwartz, G. K. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2016.69.0032 · Cited by 358
“Results from the phase III MONALEESA-2 study, which randomly assigned patients with treatment-naı̈ve HR-positive, HER2-negative ABC to ribociclib plus letrozole versus placebo plus letrozole were recently reported and showed a significant improvement in PFS for that combination, which resulted in regulatory approval.(…”
MethodBurstein, H. J., Somerfield, M. R., Barton, D. L., Dorris, A., Fallowfield, L. J., Jain, D., Johnston, S. R. D., Korde, L. A., Litton, J. K., Macrae, E. R., et al. (2021) · Journal of Clinical Oncology · doi:10.1200/jco.21.01392 · Cited by 336
Signaling Pathways in Cancer: Therapeutic Targets, Combinatorial Treatments, and New Developments
Yip, H. Y. K., & Papa, A. (2021) · Cells · doi:10.3390/cells10030659 · Cited by 341
“Except for abemaciclib, which can be used as monotherapy in refractory ER+/Her2- breast cancers [186], ribociclib and palbociclib are currently used in combination with aromatase inhibitors, or with fulvestrant for ER+ luminal breast cancers [182,187].”
BackgroundCDK4/6 inhibition in breast cancer: current practice and future directions
Pernas, S., Tolaney, S. M., Winer, E. P., & Goel, S. (2018) · Therapeutic Advances in Medical Oncology · doi:10.1177/1758835918786451 · Cited by 316
Self-citationCyclin-dependent protein kinases and cell cycle regulation in biology and disease
Pellarin, I., Dall’Acqua, A., Favero, A., Segatto, I., Rossi, V., Crestan, N., Karimbayli, J., Belletti, B., & Baldassarre, G. (2025) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-02080-z · Cited by 381
ESR1 mutations in breast cancer
Dustin, D. J., Gu, G., & Fuqua, S. A. W. (2019) · Cancer · doi:10.1002/cncr.32345 · Cited by 321
A comprehensive review of protein kinase inhibitors for cancer therapy
Kannaiyan, R., & Mahadevan, D. (2018) · Expert Review of Anticancer Therapy · doi:10.1080/14737140.2018.1527688 · Cited by 315
Current State of Breast Cancer Diagnosis, Treatment, and Theranostics
Bhushan, A., Gonsalves, A., & Menon, J. U. (2021) · Pharmaceutics · doi:10.3390/pharmaceutics13050723 · Cited by 339
Transcription-Associated Cyclin-Dependent Kinases as Targets and Biomarkers for Cancer Therapy
Chou, J., Quigley, D. A., Robinson, T. M., Feng, F. Y.-C., & Ashworth, A. (2020) · Cancer Discovery · doi:10.1158/2159-8290.cd-19-0528 · Cited by 297
Slamon, D. J., Neven, P., Chia, S., Jerusalem, G., De Laurentiis, M., Im, S., Petrakova, K., Valeria Bianchi, G., Martín, M., Nusch, A., et al. (2021) · Annals of Oncology · doi:10.1016/j.annonc.2021.05.353 · Cited by 281
Self-citationGao, J. J., Cheng, J., Bloomquist, E. W., Sanchez, J., Wedam, S. B., Singh, H., Amiri‐Kordestani, L., Ibrahim, A., Sridhara, R., Goldberg, K. B., et al. (2019) · The Lancet Oncology · doi:10.1016/s1470-2045(19)30804-6 · Cited by 295
The Strange Case of CDK4/6 Inhibitors: Mechanisms, Resistance, and Combination Strategies
Knudsen, E. S., & Witkiewicz, A. K. (2017) · Trends in cancer · doi:10.1016/j.trecan.2016.11.006 · Cited by 289
The CDK4/6 inhibitor revolution — a game-changing era for breast cancer treatment
Morrison, L., Loibl, S., & Turner, N. C. (2023) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-023-00840-4 · Cited by 290
Small Molecule Kinase Inhibitor Drugs (1995–2021): Medical Indication, Pharmacology, and Synthesis
Ayala-Aguilera, C. C., Valero, T., Lorente‐Macías, Á., Baillache, D. J., Croke, S., & Unciti‐Broceta, A. (2021) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.1c00963 · Cited by 294
Progress in adjuvant systemic therapy for breast cancer
Ponde, N. F., Zardavas, D., & Piccart, M. J. (2018) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-018-0089-9 · Cited by 283
Lu, Y.-S., Im, S.-A., Colleoni, M., Franke, F., Bardia, A., Cardoso, F., Harbeck, N., Hurvitz, S., Chow, L., Sohn, J., et al. (2022) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-21-3032 · Cited by 287
Time trends of overall survival among metastatic breast cancer patients in the real-life ESME cohort
Gobbini, É., Ezzalfani, M., Dieras, V. C., Bachelot, T., Brain, E. G. C., Debled, M., Jacot, W., Mouret‐Reynier, M., Gonçalvès, A., Dalenc, F., et al. (2018) · European Journal of Cancer · doi:10.1016/j.ejca.2018.03.015 · Cited by 281
Self-citationJiang, Z., Li, W., Hu, X., Zhang, Q., Sun, T., Cui, S., Wang, S., Ouyang, Q., Yin, Y., Geng, C., et al. (2019) · The Lancet Oncology · doi:10.1016/s1470-2045(19)30164-0 · Cited by 270
Cristofanilli, M., Pierga, J., Reuben, J. M., RADEMAKER, A. W., Davis, A. A., Peeters, D. J. E., Fehm, T. N., Nolè, F., Gisbert‐Criado, R., Mavroudis, D., et al. (2018) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2018.12.004 · Cited by 278
Self-citationPTEN Loss Mediates Clinical Cross-Resistance to CDK4/6 and PI3Kα Inhibitors in Breast Cancer
Costa, C., Wang, Y., Ly, A., Hosono, Y., Murchie, E., Walmsley, C. S., Huynh, T. G., Healy, C., Peterson, R., Yanase, S., et al. (2019) · Cancer Discovery · doi:10.1158/2159-8290.cd-18-0830 · Cited by 276
Single-Cell Dynamics Determines Response to CDK4/6 Inhibition in Triple-Negative Breast Cancer
Asghar, U. S., Barr, A. R., Cutts, R., Beaney, M., Babina, I. S., Sampath, D., Giltnane, J. M., Lacap, J. A., Crocker, L., Young, A. E., et al. (2017) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-17-0369 · Cited by 272
“CDK4/6 inhibition is a proven therapeutic strategy for estrogen receptor–positive (ERþ) breast cancers (3, 4), with selective CDK4/6 inhibitors (palbociclib and ribociclib) demonstrating substantial improvements in progression-free survival [PALOMA1 (3), PALOMA2 (5), PALOMA3 (4) and MONALEESA-2 (6)] in phase two and t…”
Hafner, M., Mills, C. E., Subramanian, K., Chen, C., Chung, M., Boswell, S. A., Everley, R. A., Liu, C., Walmsley, C. S., Juric, D., et al. (2019) · Cell Chemical Biology · doi:10.1016/j.chembiol.2019.05.005 · Cited by 250
Mayer, E. L., Dueck, A. C., Martín, M., Rubovszky, G., Burstein, H. J., Bellet, M., Miller, K. D., Zdenkowski, N., Winer, E. P., Pfeiler, G., et al. (2021) · The Lancet Oncology · doi:10.1016/s1470-2045(20)30642-2 · Cited by 260
Self-citationTripathy, D., Bardia, A., & Sellers, W. R. (2017) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-16-3157 · Cited by 247
“9% in the ribociclib and placebo groups, respectively (46).”
InfluentialAdjuvant Palbociclib for Early Breast Cancer: The PALLAS Trial Results (ABCSG-42/AFT-05/BIG-14-03)
Gnant, M., Dueck, A. C., Frantal, S., Martin, M., Burstein, H. J., Greil, R., Fox, P., Wolff, A. C., Chan, A., Winer, E. P., et al. (2022) · Journal of Clinical Oncology · doi:10.1200/jco.21.02554 · Cited by 235
Self-citationJohnston, S. R. D., Puhalla, S., Wheatley, D. A., Ring, A. E., Barry, P. A., Holcombe, C., Boileau, J. F., Provencher, L., Robidoux, A., Rimawi, M. F., et al. (2018) · Journal of Clinical Oncology · doi:10.1200/jco.18.01624 · Cited by 228
PD-1/PD-L1 Targeting in Breast Cancer: The First Clinical Evidences are Emerging—A Literature Review
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Endocrine Resistance in Hormone Receptor Positive Breast Cancer–From Mechanism to Therapy
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“The results from this trial presented with an extension in the PFS for the cohort of patients treated with ribociclib plus letrozole when compared with the placebo group of letrozole alone (228).”
Combined CDK4/6 and PI3Kα Inhibition Is Synergistic and Immunogenic in Triple-Negative Breast Cancer
Teo, Z. L., Versaci, S., Dushyanthen, S., Caramia, F., Savas, P., Mintoff, C. P., Zethoven, M., Virassamy, B., Luen, S. J., McArthur, G. A., et al. (2017) · Cancer Research · doi:10.1158/0008-5472.can-17-2210 · Cited by 196
Advances in the treatment of advanced oestrogen-receptor-positive breast cancer
Turner, N. C., Neven, P., Loibl, S., & Andre, F. (2017) · The Lancet · doi:10.1016/s0140-6736(16)32419-9 · Cited by 205
Self-citationA Review of Fulvestrant in Breast Cancer
Nathan, M. R., & Schmid, P. (2017) · Oncology and Therapy · doi:10.1007/s40487-017-0046-2 · Cited by 218
“Both palbociclib and ribociclib have been shown to substantially increase PFS in combination with the aromatase inhibitor letrozole in patients without prior endocrine treatment for metastatic breast cancer (PALOMA-2 study [26]; MONALEESA-2 study [27].”
BackgroundCyclin-dependent kinase 4/6 inhibitors in breast cancer: palbociclib, ribociclib, and abemaciclib
Kwapisz, D. M. (2017) · Breast Cancer Research and Treatment · doi:10.1007/s10549-017-4385-3 · Cited by 210
“3%), nausea, infections (mainly urinary and upper respiratory tract infections), fatigue, and diarrhea [51].”
BackgroundMethodInfluentialTriple-Negative Breast Cancer and the Potential for Targeted Therapy
Jhan, J.-R., & Andrechek, E. R. (2017) · Pharmacogenomics · doi:10.2217/pgs-2017-0117 · Cited by 205
Wu, Q., Qian, W., Sun, X., & Jiang, S. (2022) · Journal of Hematology & Oncology · doi:10.1186/s13045-022-01362-9 · Cited by 208
Finn, R. S., Liu, Y., Zhu, Z., Martín, M., Rugo, H. S., Dieras, V. C., Im, S., Gelmon, K. A., Harbeck, N., Lu, D. R., et al. (2019) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-19-0751 · Cited by 204
“Large randomized studies have consistently shown that CDK4/6 inhibitors add to endocrine therapy activity in HR+/HER2– ABC, as evidenced by improvements in median PFS (9, 11-13).”
BackgroundTargeting Cell Cycle in Breast Cancer: CDK4/6 Inhibitors
Piezzo, M., Cocco, S., Caputo, R., Cianniello, D., Gioia, G. D., Lauro, V. D., Fusco, G., Martinelli, C., Nuzzo, F., Pensabene, M., et al. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21186479 · Cited by 212
Sparano, J. A., O’Neill, A., Alpaugh, K. R., Wolff, A. C., Northfelt, D., Dang, C. T., Sledge, G. W., & Miller, K. D. (2018) · JAMA Oncology · doi:10.1001/jamaoncol.2018.2574 · Cited by 205
CDK 4/6 Inhibitors as Single Agent in Advanced Solid Tumors
Schettini, F., Santo, I. D., Rea, C. G., Placido, P. D., Formisano, L., Giuliano, M., Arpino, G., Laurentiis, M. D., Puglisi, F., Placido, S. D., et al. (2018) · Frontiers in Oncology · doi:10.3389/fonc.2018.00608 · Cited by 201
“Paloma 2 (29) Paloma 3 (30) Monaleesa 2 (31) Monaleesa 7 (36) Monaleesa 3 (32) Monarch-3 (33) Monarch-2 (34)”
BackgroundClinical utility of circulating tumor cells: an update
Vasseur, A., Kiavué, N., Bidard, F., Pierga, J., & Cabel, L. (2020) · Molecular Oncology · doi:10.1002/1878-0261.12869 · Cited by 204
Metadata
- Authors
- Hortobagyi, G. N., Stemmer, S. M., Burris, H. A., Yap, Y.-S., Sonke, G. S., Paluch-Shimon, S., Campone, M., Blackwell, K. L., André, F., Winer, E. P., Janni, W., Verma, S., Conte, P., Arteaga, C. L., Cameron, D. A., Petrakova, K., Hart, L. L., Villanueva, C., Chan, A., Jakobsen, E., Nusch, A., Burdaeva, O., Grischke, E.-M., Alba, E., Wist, E., Marschner, N., Favret, A. M., Yardley, D., Bachelot, T., Tseng, L.-M., Blau, S., Xuan, F., Souami, F., Miller, M., Germa, C., Hirawat, S., & O’Shaughnessy, J.
- Affiliations
- From the University of Texas M.D. Anderson Cancer Center, Houston (G.N.H.), and Texas Oncology–Baylor Charles A. Sammons Cancer Center and the U.S. Oncology Network, Dallas (J.O.) — all in Texas; Davidoff Center, Rabin Medical Center, Tel Aviv University, Tel Aviv (S.M.S.), and Sheba Medical Center, Ramat Gan (S.P.-S.) — both in Israel; the Sarah Cannon Research Institute (H.A.B., D.Y.), Vanderbilt–Ingram Cancer Center (C.L.A.), and Tennessee Oncology (D.Y.) — all in Nashville; National Cancer Center...
- The University of Texas MD Anderson Cancer Center (US)
- Université Paris-Sud (FR)
- Oslo University Hospital (NO)
- Novartis (Switzerland) (CH)
- ORCID
- Stemmer, Salomon M.
- Burris, Howard A.
- Yap, Yoon-Sim
- Sonke, Gabe S.
- Campone, Mario
- Blackwell, Kimberly L.
- André, Fabrice
- Winer, Eric P.
- Janni, Wolfgang
- Verma, Sunil
- Conte, Pierfranco
- Arteaga, Carlos L.
- Cameron, David A.
- Chan, Arlene
- Jakobsen, Erik
- Grischke, Eva-Maria
- Alba, Emilio
- Wist, Erik
- Marschner, Norbert
- Favret, Anne M.
- Yardley, Denise
- Bachelot, Thomas
- Tseng, Ling-Ming
- Blau, Sibel
- Xuan, Fengjuan
- Miller, Michelle
- Germa, Caroline
- O’Shaughnessy, Joyce
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2016-11-03
- Volume
- 375
- Issue
- 18
- Pages
- 1738-1748
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2528767298
- Cited by
- 2,039
- References
- 24
- Citations by year
- 2026: 167 · 2025: 218 · 2024: 203 · 2023: 214 · 2022: 187 · 2021: 247 · 2020: 206 · 2019: 173 · 2018: 237 · 2017: 166 · 2016: 17
- FWCI
- 176.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Padua Research Archive (University of Padova) (submittedVersion, other-oa)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
- Funders
- Amgen
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Sanofi
- Spectrum Pharmaceuticals
- Celgene
- Exelixis
- Celldex Therapeutics
- TG Therapeutics
- Astex Pharmaceuticals
- Agios Pharmaceuticals
- Jounce Therapeutics
- Mersana Therapeutics
- Incyte
- G1 Therapeutics
- Eisai
- Astellas Pharma
- Ipsen
- Genentech
- Chugai Pharmaceutical
- Novartis Institutes for BioMedical Research
- Loxo Oncology
- Topics
- Health Sciences › Medicine › Oncology › Advanced Breast Cancer Therapies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Health Sciences › Medicine › Oncology › PARP inhibition in cancer therapy
- Keywords
- ribociclib, CDK4/6 inhibitors, hormone receptor-positive HER2-negative breast cancer, advanced breast cancer, first-line therapy, letrozole, endocrine therapy resistance, progression-free survival, myelosuppression, neutropenia, leukopenia
- MeSH terms
- Letrozole, Adult, Aged, Aged, 80 and over, Aminopyridines, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Double-Blind Method, Drug Administration Schedule, Female, Humans, Middle Aged, Neoplasm Staging, Nitriles, Purines, Receptors, Estrogen, Receptors, Progesterone, Triazoles, Disease-Free Survival, Erb-b2 Receptor Tyrosine Kinases, Kaplan-Meier Estimate
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