Ribociclib in the treatment of HR+ HER2-negative metastatic breast cancer: updated results from the randomized clinical trials and their role in the clinical practice

The luminal HER2-negative subtype is the dominant variant of metastatic breast cancer; modern combined endocrine therapy with CDK4/6 inhibitors due to significantly change the prognosis of the disease, not only for increasing progression free survival, but also for significantly prolonging the life expectancy of patients. This review presents the features of the mechanism of action of CDK4/6 inhibitors, the most significant and updated results of large, randomized trials with ribociclib (MONALEESA-2, MONALEESA-3, and MONALEESA-7) assessing the efficacy and safety of combined endocrine therapy with various endocrine partners in a population of premenopausal women and menopausal patients. The prospects for the use of CDK4/6 inhibitors for therapy patients with visceral crisis are shown.

Use of LH-RH agonists in the treatment of breast disease

SynopsisThe effects of LH-RH agonists in advanced breast cancer patients are reviewed and compared to the efficacy of surgical ablation of the ovaries and X-ray induced menopause in the treatment of this disease. In both pre- and postmenopausal women, LH-RH agonists produce pituitary gland desensitisation and a fall in concentrations of LH and FSH. In premenopausal patients plasma progesterone and oestradiol levels fall to the castrate or postmenopausal range within three to four weeks. Tumour remissions have been observed in approximately 30% of premenopausal women (50% ER-positive) and approximately 10% of postmenopausal patients. The mechanism of action of LH-RH agonists is discussed and their current application to combined endocrine therapy, early breast cancer and mastalgia briefly outlined.