Overall survival results for Kisqali in combination with endocrine therapy in phase III MONALEESA-7 trial for (HR+/HER2-) advanced or metastatic breast cancer.

Novartis has announced statistically significant overall survival (OS) results for Kisqali in combination with endocrine therapy. The Phase III MONALEESA-7 trial evaluated Kisqali plus endocrine therapy (goserelin plus either an aromatase inhibitor or tamoxifen) as initial treatment compared to endocrine therapy alone in pre- and perimenopausal women with hormone receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-) advanced or metastatic breast cancer.

MONALEESA-7 overall survival results will be featured in a press briefing , presented as a late-breaker at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract# LBA1008), and will be published in The New England Journal of Medicine.

The significant extension in survival met the early efficacy stopping criteria at a pre-specified interim analysis following 192 deaths (median OS, not reached vs. 40.9 [95% CI: 37.8-NE] months; HR=0.712 [0.535-0.948]; p=0.00973). Overall survival rates in the intent-to-treat population (n=672) at 42 months were 70.2% for Kisqali combination therapy compared to 46.0% for endocrine therapy alone. At the time of data cut-off, 35% of women taking Kisqali combination therapy were continuing the treatment. No new safety signals were observed. Kisqali is not indicated for use with tamoxifen.

"Overall survival benefit is considered the 'gold standard' in cancer trials but is challenging to achieve in HR+/HER2- metastatic breast cancer. MONALEESA-7 reached this important endpoint earlier than anticipated," said Sara Hurvitz, MD, Medical Director of the Jonsson Comprehensive Cancer Center Clinical Research Unit and Director of the Breast Cancer Clinical Trials Program at UCLA. "Impactful results like these ribociclib findings are what we wish for in every clinical trial, and to achieve overall survival improvement in an incurable disease, like metastatic breast cancer, is truly an outstanding advancement for patients."

Results from subgroup analyses showed that Kisqali plus an aromatase inhibitor demonstrated a 30.0% reduced risk of death compared to an aromatase inhibitor alone (median OS not reached vs. 40.7 months [37.4-NE]; HR=0.699 [0.501-0.976]), and Kisqali plus tamoxifen demonstrated a 20.9% reduced risk of death compared to tamoxifen alone (HR=0.791 [0.454-1.377])[1]. Kisqali is not indicated for use with tamoxifen. In the MONALEESA-7 primary analysis, increase in QTcF was on average greater and equal to 10 milliseconds in people taking tamoxifen plus placebo compared those taking aromatase inhibitor and placebo.

"Kisqali has characteristics that make it distinct from other CDK4/6 inhibitors. For one, Kisqali shows especially strong inhibition against CDK4. In pre-clinical data, Kisqali is four- to five-fold more potent against CDK4 compared to CDK6. CDK4 is likely the dominant CDK in breast cancer and a pivotal driver of disease progression," said Jeff Engelman, MD, Global Head of Oncology Research, Novartis Institutes for BioMedical Research.