BACKGROUND: The CDK4/6 inhibitor, ribociclib in combination with endocrine therapy significantly improved progression-free survival in the first line setting in post-menopausal patients with HR+/HER2- advanced breast cancer (ABC) in a pivotal phase 3, placebo-controlled trial (MONALEESA-2) and demonstrated superior overall survival in premenopausal patients with HR+/HER2- ABC (MONALEESA-7). The multinational, phase 3b, CompLEEment-1 trial, which assessed the safety and efficacy of ribociclib plus letrozole in a broader population of patients who have not received prior endocrine therapy for advanced disease, is the largest phase 3 clinical trial to date to evaluate the safety and efficacy of a CDK4/6 inhibitor. We report a subanalysis of data from patients (N = 339) enrolled in the central and south European countries of the SERCE (Southern Europe, RUC, Central Europe) cluster of CompLEEment-1. PATIENTS AND METHODS: Men and women of any menopausal status with HR+/HER2- ABC received once-daily oral ribociclib 600 mg (3-weeks on/1-week-off), plus letrozole 2.5 mg continuously. Men/premenopausal women also received a GnRH-agonist. The primary outcome was the number of patients with adverse events (AEs) over a timeframe of approximately 36 months. Time-to-progression, overall response rate, and clinical benefit rate were also measured. RESULTS: Safety results in the SERCE subgroup were consistent with those in the pivotal clinical trials of ribociclib in combination with endocrine therapy. Treatment-related AEs leading to dose adjustments/interruption occurred in 63.1% of patients but led to treatment discontinuation in only 10.6%. The most common treatment-related AEs of grade ≥ 3 were neutropenia and transaminase elevations. There were no fatal treatment-related events. CONCLUSIONS: These findings from the SERCE subgroup support the safety and manageable tolerability of ribociclib in a broad range of patients with HR+/HER2- ABC more representative of patients in real-world clinical practice.

Clinic of Comprehensive Cancer Care Masaryk Memorial Cancer Institute Brno Czech Republic

Department of Clinical Oncology Wroclaw University of Medicine Wrocław Poland and Breast Unit Lower Silesian Oncology Centre Wroclaw Poland

Department of Medical Oncology Institute of Oncology Ljubljana Ljubljana Slovenia

Department of Oncological Internal Medicine and Clinical Pharmacology National Institute of Oncology Budapest Hungary

Euromedica General Clinic of Thessaloniki Thessaloniki Greece

Medical Oncology Clinic Multiprofile Hospital for Active Treatment Nadezhda Sofia Sofia Bulgaria

Novartis Slovakia s r o Bratislava Slovakia

Regional Cancer Center Poprad Slovakia

Talpiot medical leadership program Institute of Oncology Chaim Sheba Medical Center Tel Hashomer; affiliated to the Sackler School of Medicine Tel Aviv University Tel Aviv Israel

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