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‘Kisqali can treat premenopausal breast cancer patients without removing ovaries’

Shim Hyun-tai  Published 2020.05.01  16:45  Updated 2020.05.01 16:45

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“In Asia, where women get breast cancer far younger than in the West, the share of premenopausal patients is also higher. MONALEESA-7 study showed that the combined treatment of Kisqali (Ingredient: ribociclib) and endocrine therapy could reduce the risk of death of premenopausal breast cancer patients by 30 percent compared to endocrine therapy alone.”

Professor Im Seok-ah of the Department of Hemato Oncology at Seoul National University Hospital said so during the online media seminar held by Novartis on Wednesday.

Professor Im Seok-ah of the Department of Hemato Oncology at Seoul National University Hospital makes a presentation about MONALEESA-7 clinical trial on Novartis’ Kisqali, on Wednesday.

Kisqali is a drug used to treat hormone-receptor-positive (HR+), HER2 negative (HER2-) breast cancer that is advanced or has spread to other parts of the body. It is used with an aromatase inhibitor (a type of hormone therapy) in women who have not been treated with hormone therapy.

MONALEESA-7 is a phase 3 clinical trial, which evaluated a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor with endocrine therapy, which provided greater benefit concerning progression-free survival (PFS) in premenopausal breast cancer patients.

The result showed that the median PFS of the combination therapy with 23.8 months and endocrine-only group with 13 months. The researchers also analyzed an additional group only with Asians and found that the group treated with Kisqali combined therapy showed 24.7 months, which was 14 months longer than that of endocrine therapy alone.

Clinical studies are conducted mainly on postmenopausal patients with breast cancer, which could not be applied to patients in Korea. Unlike the West, where the overall survival rate of breast cancer patients is steadily rising, the main reason behind the falling survival rate in Asia is due to the differences of breast cancer between pre- and postmenopausal patients.

In particular, metastatic breast cancer that occurs in premenopausal women is more aggressive than postmenopausal cases and requires more active treatment.

Hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)–negative, or metastatic breast cancer patients have to receive long chemotherapy because of the high risk of relapse.

Besides, the prognosis of metastatic breast cancer patients is known to be particularly poor if they have liver metastases, progesterone receptor-negative, high tumor grade, and short recurrence periods.

Professor Im said that about half of breast cancer patients in Asian countries are premenopausal or perimenopausal. She added that about 18,000 new breast cancer patients occur every year, and 48 percent of them are premenopausal patients.

Premenopausal breast cancer patients take a significant part in all breast cancer patients. Unlike Western patients, who usually develop breast cancer in their 60s and 70s after menopause, relatively younger groups, and premenopausal patients are found in Asia.

Im said that there is a significant difference in terms of statistical improvement in overall survival with the combined treatment with endocrine therapy as a primary treatment compared to other CDK 4/6 inhibitors.

The development of medical technology and therapeutic allowed the treatment of metastatic breast cancer to focus on extending the survival period and securing the maximum quality of life.

She emphasized that if patients can get insurance benefits for Kisqali, the ovarian resection problem that premenopausal patients had to receive to use the CDK4/6 inhibitor can be solved.

shim531@docdocdoc.co.kr

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