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An Indirect Treatment Comparison of the Effectiveness of Ribociclib Combined With Non-steroidal Aromatase Inhibitors vs. Tamoxifen for the Adjuvant Treatment of Premenopausal Women With Hormon Receptor-positive, HER2-negative Early Breast Cancer

An Indirect Treatment Comparison of the Effectiveness of Ribociclib Combined With Non-steroidal Aromatase Inhibitors vs. Tamoxifen for the Adjuvant Treatment of Premenopausal Women With Hormon Receptor-positive, HER2-negative Early Breast Cancer (IRINA)

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT07072013
Acronym
IRINA
Enrollment
1937
Registered
2025-07-18
Start date
2023-09-08
Completion date
2025-04-24
Last updated
2025-07-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Breast Cancer

Keywords

Ribociclib,, early breast cancer,, indirect treatment comparison,, tamoxifen,, premenopausal

Brief summary

The purpose of this indirect treatment comparison (ITC) was to generate comparative evidence on the effectiveness and safety in premenopausal women of ribociclib+Non-steroidal Aromatase Inhibitor (NSAI)+Ovarian Function Suppression (OFS) investigated in the global NATALEE trial (CLEE011O12301C, NCT 03701334) vs. tamoxifen±OFS using patients treated in German routine care as external control

Detailed description

Data of premenopausal Early Breast Cancer (EBC) patients treated with tamoxifen±OFS in German routine care were used as external control for a patient-level adjusted ITC of ribociclib+NSAI+OFS vs. tamoxifen±OFS. The ribociclib+NSAI+OFS arm utilized data of premenopausal women in the NATALEE clinical trial. The tamoxifen±OFS arm as the external control used a subset of data collected in the CLEAR-B project (NCT05870813).

Interventions

OTHERribociclib

This is an observational study. There is no treatment allocation. The decision to initiate ribociclib was based solely on clinical judgement.

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Observational model
COHORT
Time perspective
RETROSPECTIVE

Eligibility

Sex/Gender
FEMALE
Age
18 Years to 60 Years
Healthy volunteers
No

Inclusion criteria

* Premenopausal women between 18 and 60 years * HR-positive, HER2-negative EBC without distant metastases * Patients must belong to one of the following categories according to the American Joint Committee on Cancer (AJCC): * Anatomic Stage Group III, * Anatomic Stage Group IIB, * Anatomic Stage Group IIA that it either: * N1, * N0 with the following criteria: * Grade 3 * Grade 2, with any of the following criteria: * Ki67 ≥ 20 % or * Oncotype DX Breast Recurrence Score ≥ 26 or * Prosigna/PAM50 categorized as high risk or * MammaPrint categorized as high risk or * EndoPredict EPclin Risk Score categorized as high risk. * Patients with Cyclin-dependent Kinase 4/6 (CDK4/6) inhibitor treatment other than ribociclib+NSAI+OFS were excluded * Patients in a bad general condition \[Eastern Cooperative Oncology Group (ECOG) Status \> 1\] or with a limited life expectancy \< 5 years were excluded

Design outcomes

Primary

MeasureTime frameDescription
Invasive Disease-Free Survival (iDFS)96 monthsInvasive Disease-Free Survival (iDFS) is defined as the time (in months) from the reference date to the date of the first contributing event and is censored otherwise. Contributing events according to the Standardized Definitions for Efficacy End Points (in Adjuvant Breast Cancer Trials) (STEEP) are * invasive ipsilateral breast tumor recurrence, * local/regional invasive recurrence, * distant recurrence, * death from BC, * death from non-BC cause, * death from unknown cause, * invasive contralateral BC, * or second primary non-breast invasive cancer (excluding basal and squamous cell carcinomas of the skin, or new in situ carcinomas of any site).
Distant Disease-Free Survival (dDFS)96 monthsDistant Disease-Free Survival (dDFS) is defined as the time (in months) from the reference date to the date of first contributing event. Contributing events according to the STEEP criteria are: * distant recurrence * death from BC * death from a non-BC cause * death from an unknown cause or * a second primary non-breast invasive cancer (excluding basal and squamous cell carcinomas of the skin, or new in situ carcinomas of any site).
Recurrence-Free Survival (RFS)96 monthsRecurrence-Free Survival (RFS) is defined as the time (in months) from the reference date to the date of the first contributing event and censored otherwise. Contributing events according to STEEP are * invasive ipsilateral breast tumor recurrence, * local/regional invasive recurrence, * distant recurrence, * death from BC, * death from a non-BC cause, * death from an unknown cause.
Overall Survival (OS)96 monthsOverall survival (OS) is defined as the time (in months) from the reference date to the date of death from any cause. Time for censored patients is defined as the time from the reference date to last contact date.
Treatment Terminations (TT)96 monthsFor the ribociclib+NSAI+OFS arm, Treatment Termination (TT) is defined as permanent treatment termination of treatment. For the tamoxifen±OFS arm, TT is defined as permanent termination of adjuvant tamoxifen.
Treatment Terminations due to Toxicity (TT_Tox)96 monthsFor the ribociclib+NSAI+OFS arm, Treatment Termination due to Toxicity (TT\_Tox) is defined as permanent treatment termination due to toxicity within three years of beginning ribociclib. For the tamoxifen±OFS arm, TT\_Tox is defined as permanent treatment termination of adjuvant tamoxifen due to toxicity.

Countries

Germany

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026