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Poster Display session 2

1109 - First Canadian Interim Analysis from the Phase IIIb CompLEEment-1 Ribociclib + Letrozole HR+ HER2- Advanced Breast Cancer Trial

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Tumour Site

Breast Cancer

Presenters

Cristiano Ferrario

Citation

Annals of Oncology (2019) 30 (suppl_5): v104-v142. 10.1093/annonc/mdz242

Authors

C. Ferrario1, E. Warner2, N. Califaretti3, A.A. Joy4, S. Chia5, J. Wu6, J.P. Zarate6, M. Lakshmi6, S.R. Perri7, S. Haftchenary7, S.F. Dent8

Author affiliations

  • 1 Medical Oncology, Jewish General Hospital McGill University, H3T 1E2 - Montreal/CA
  • 2 Medical Oncology, Sunnybrook Odette Cancer Center, Toronto/CA
  • 3 Medical Oncology, Grand River Regional Cancer Center, Kitchener/CA
  • 4 Department Of Medical Oncology, University of Alberta Cross Cancer Institute, T6G 1Z2 - Edmonton/CA
  • 5 Department Of Medicine, University of British Columbia, V6T 1Z4 - Vancouver/CA
  • 6 Oncology Medical Affairs, Novartis, East Hanover/US
  • 7 Oncology Medical Affairs, Novartis Pharma Canada, H951A9 - Dorval/CA
  • 8 Medical Oncology, The Ottawa Hospital Regional Cancer Centre, K1H 8L6 - Ottawa/CA

Resources

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Abstract 1109

Background

CDK4/6 inhibitor Ribociclib (RIBO) was approved by Health Canada in combination with letrozole (LET) for the treatment of HR+, HER2– advanced breast cancer (ABC) in postmenopausal women with no prior therapy for advanced disease. This was based on the significantly prolonged PFS versus placebo + LET observed in the phase 3 MONALEESA-2 trial. (NCT01958021) Here, we report the interim results for the Canadian patients (pts) enrolled in CompLEEment-1 (C-1), an open-label, phase 3b trial evaluating RIBO+LET as first-line therapy in an expanded patient population including pre-menopausal women as well as men.

Methods

Canadian pts with HR+, HER2- ABC, allowed to have received ≤1 line of prior chemotherapy and no prior endocrine therapy (ET) for ABC received RIBO+LET. Treatment regimen and study endpoints have been previously reported (De Laurentiis et al. ASCO 2018. Poster 1056).

Results

Overall, 251 Canadian pts enrolled in C-1 (N = 3255pts) were evaluated in this interim analysis (cut-off date, August 8, 2018). Median duration of exposure was 8.1 months (min; 0.0; max, 22.4). At the time of cut-off 63.3% of patients were still on treatment with the main reason for discontinuation progressive disease. Summary of demographic and baseline characteristics as well as interim efficacy and safety results are shown in Table. Most common grade ≥3 AEs were neutropenia (37.5 %), diarrhoea (2.8%) and fatigue (1.2%). Further details on the clinical impact of adverse events on treatment (i.e. action taken such as dose reductions, interruptions, etc) will be compared to the overall patient population and presented.Table:

337P (N = 251)

Patients treated, n (%) Treated Treatment ongoing DiscontinuedN/A 251 (100) 159 (63.3) 92 (36.7)
Main reasons for d/c PD Treatment related AE OtherN/A 41 (16.3) 23 (9.2) 22 (8.8)
Median age, y58.0
Age category <70 y %; ≥ 70 y, n (%)200 (79.7); 51 (20.3)
Postmenopausal, %; Pre/peri-menopausal, n (%)189 (75.3):62 (24.7)
ECOG PS 0/1/2, n (%)125 (49.8)/115 (45.8)/11 (4.4)
Disease History
Extent of metastatic disease, n (%) Bone Bone only CNS Visceral Lung Liver OtherN/A 190 (75.7) 53 (21.1) 4 (1.6) 167 (66.5) 118 (47.0) 65 (25.9) 41 (16.3)
Number of metastatic sites, % 0-2 3-5+ Disease free interval, n (%) De novo Non de novo ≤12 months; >12 monthsN/A 131 (52.2) 120 (47.8) N/A 58 (23.1) 192 (76.5) 34 (13.5); 158 (63)
Best overall response, n (%)
CR PR Non-CR/Non-PD SD PD1 (0.4) 52 (20.7) 89 (35.5) 63 (25.1) 12 (4.8)
ORR, n (%); CBR, n (%)53 (21.1); 166 (66.1)
Clinical impact of AEs
Dose reduced due to: Neutropenia Alanine aminotransferase increased Aspartate aminotransferase increasedN/A 34 (13.5) 6 (2.4) 2 (0.8)
Treatment related SAE, %12 (4.8)
Treatment related AE leading to d/c, %23 (9.2)

Conclusions

Canadian pts represent a diverse population. Interim safety and efficacy results are generally consistent with the overall study: response rate - 21.1% for Canada v.s. 20.5% overall; clinical benefit rate - 66.1% Canada v.s 66.1% Overall, safety results were consistent with those observed in RIBO pivotal studies and no new safety signals were observed.

Clinical trial identification

NCT02941926.

Editorial acknowledgement

Legal entity responsible for the study

Novartis.

Funding

Novartis.

Disclosure

C. Ferrario: Honoraria (self), Research grant / Funding (institution): Pfizer; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Bayer; Honoraria (self), Speaker Bureau / Expert testimony, Research grant / Funding (institution), Travel / Accommodation / Expenses: Novartis; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): AstraZeneca; Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Merck; Honoraria (self): Astellas Pharma; Advisory / Consultancy: Genomic Health; Research grant / Funding (self): Amgen; Research grant / Funding (institution): Casadian therapeutics; Research grant / Funding (institution): Lilly; Research grant / Funding (institution), Travel / Accommodation / Expenses: Roche; Research grant / Funding (institution): Janssen Oncology; Research grant / Funding (institution): Zymeworks. A.A. Joy: Advisory / Consultancy: Novartis; Advisory / Consultancy: Roche; Advisory / Consultancy: Teva; Advisory / Consultancy: Eli Lilly; Advisory / Consultancy: Genomic health; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Amgen; Advisory / Consultancy: BMS. S.F. Dent: Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (institution): Novartis. All other authors have declared no conflicts of interest.

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