Adherence and Safety of Ribociclib Plus Aromatase Inhibitors in Patients With Early Stage, HR+ and HER2- Breast Cancer

Trial statusNot yet recruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexAll
Age18+
SponsorInstitute of Oncology Ljubljana

About this trial

Breast cancer is the most common malignancy in women, with HR+/HER2- early breast cancer accounting for approximately 70% of cases. Although adjuvant endocrine therapy substantially reduces the risk of recurrence, a clinically meaningful proportion of patients, particularly those with intermediate- and high-risk disease, still experience relapse. The addition of CDK4/6 inhibitors such as ribociclib to endocrine therapy has demonstrated significant improvement in invasive disease-free survival (iDFS) and is now part of standard adjuvant treatment for selected patients. However, the real-world effectiveness of prolonged oral therapy depends heavily on patient adherence, which may be negatively affected by treatment duration, adverse events, and the absence of immediate perceived benefit. Evidence regarding adherence to adjuvant ribociclib therapy in routine clinical practice remains limited. This study therefore aims to evaluate whether a structured adherence-support intervention can improve treatment adherence during ribociclib therapy and to explore the relationship between adherence and long-term clinical outcomes, including iDFS.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Female or male patient prescribed with ribociclib in combination with an aromatase inhibitor independently of trial participation

Patient was prescribed ribociclib independently of this trial protocol and has not yet started cycle 1

Patient is ≥ 18 years-old at the time of ICF signature

Patient has mandatory Slovenian health insurance

Disqualifiers

Patient is not treated with the combination of ribociclib and aromatase inhibitor for Early BC

Metastatic Hormone Receptor positive and HER2- negative BC

Any medical condition that, in the opinion of the investigator, would interfere with adherence participation in the trial (i.e. significant cognitive impairment, psychiatric condition)

Language barrier that precludes informed consent or meaningful participation in the adherence intervention

Trial design

Design model

Parallel

Treatments tested in this trial

  • Adherence package consisting of additional education and adherence reminders

    Behavioral

    Adherence package consisting of additional education and adherence reminders

Treatment groups

90 Participants
are divided into 2 treatment groups
Group A: Intervention arm: structured adherence-support packageExperimental treatment 1 intervention
Group B: Control arm: usual care according to local practiceNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

Proportion of days covered (PDC)

The primary objective is to show that a structured adherence package increases mean adherence, expressed as days\_taken/days\_prescribed. To maintain comparability with previous studies, we will use the independent samples t test with alpha=0.05 to compare the means between groups. H0: there is no difference in mean PDC between groups (SoC + behavioural intervention vs SoC)

Time frame
Randomization to end of treatment with ribociclib: 3 years from enrollment

Secondary outcomes

1

iDFS

estimate invasive disease free survival (iDFS) in both treatment groups

Time frame
5 years form randomization
2

5-year survival

estimate association between adherence and survival

Time frame
5 years form randomization

Other outcomes

Sponsors and contacts

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