Dr El-Saghir on the Investigation of Ribociclib Plus ET in HR+, HER2– Advanced Breast Cancer

“The RIGHT Choice trial was a study for the management of patients with hormone receptor–positive, HER2-negative advanced breast cancer with clinically aggressive disease, which we defined as rapidly progressive and severely symptomatic visceral disease.”

Nagi S. El-Saghir, MD, FACP, FASCO, a professor of clinical medicine, head of the Division of Hematology Oncology in the Department of Internal Medicine, and director of the Breast Center of Excellence at the American, Naef K Basile Cancer Institute, University of Beirut Medical Center, discussed the inception of the phase 2 RIGHT Choice trial (NCT03839823) of ribociclib (Kisqali) plus endocrine therapy vs combination chemotherapy.

RIGHT Choice enrolled patients with hormone receptor–positive, HER2-negative advanced breast cancer, El-Sahir began. Patients had clinically aggressive disease, which was defined as the presence of rapid disease progression and symptomatic visceral disease, he added. The study also included premenopausal patients, he noted.

Prior data from the final analysis of RIGHT Choice, which were published in the Journal of Clinical Oncology, revealed that patients who received the combination (n = 112) achieved a median progression-free survival (PFS) of 21.8 months (95% CI, 17.4-26.7) compared with 12.8 months (95% CI, 10.1-18.4) in the chemotherapy arm (n = 110; HR, 0.61; 95% CI, 0.43-0.87; P = .003), El-Sahir explained. Beyond PFS benefit, patients in the ribociclib arm also experienced better quality of life compared with those who received standard chemotherapy, he concluded.

Findings from a subgroup analysis of RIGHT Choice presented during the 2025 ASCO Annual Meeting revealed that patients with liver metastases in the investigational arm (n = 54) achieved a median PFS of 18.3 months (95% CI, 10.3-24.0) compared with 12.7 months (95% CI, 7.5-21.0) in the control arm (n = 53; HR, 0.68; 95% CI, 0.42-1.11). Patients without liver metastases in the investigational and control arms achieved a median PFS of 25.2 months (95% CI, 18.6-not evaluable) and 15.4 months (95% CI, 8.8-20.0), respectively (HR, 0.57; 95% CI, 0.34-0.93).