Breast Cancer
Conditions
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
This is an observational study. There is no treatment allocation. The decision to initiate ribociclib was based solely on clinical judgement.
Sponsors
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| Invasive Disease-Free Survival (iDFS) | 96 months | Invasive 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 months | Distant 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 months | Recurrence-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 months | Overall 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 months | For 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 months | For 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