{
  "abstract": "Purpose: Adjuvant CDK4/6 inhibitors have demonstrated significant disease-free survival (DFS) benefits in high-risk early-stage hormone receptor (HR)-positive /HER2-negative breast cancer. However, real-world outcome data describing patients who would meet contemporary eligibility criteria remain limited. This study evaluates treatment outcomes in patients retrospectively classified as eligible for adjuvant ribociclib treatment.\n\nPatients and Methods: A retrospective cohort analysis was conducted using clinical data from patients with early-stage HR-positive/HER2-negative breast cancer. Eligibility for adjuvant ribociclib was assigned using the NATALEE trial-based criteria. Differences in treatment outcomes in those eligible versus ineligible patients are reported.\n\nResults: Among the 2730 patients included, 1,955 (71.6%) were high risk and would have met NATALEE eligibility, including 1,679 (85.9%) with node-positive disease, 602 (30.8%) with cT3-4 tumors, and 686 (35.1%) with grade 3 disease; 775 (28.4%) were ineligible due to lower-risk features. Across the cohort, the 5-year DFS rate was significantly worse in CDK4/6i-eligible patients compared to those deemed ineligible: 78.4% versus 91.5% (HR=2.51; 95% CI: 2.01–3.14; p<0.0001). Though median OS was not reached, survival curve separation became evident by 36 months and widened progressively. Multivariable Cox regression identified low/intermediate ER expression (<50%), node-positive disease, larger tumors (cT3-4), and grade 3 histology as independent predictors of worse overall survival. Low/intermediate ER expression was associated with significantly poorer OS (HR 1.85, 95% CI 1.27–2.70; p=0.001), while lower-grade and smaller tumors were associated with improved survival.\n\nConclusion: A significant proportion of patients in this real-world cohort would have met criteria for adjuvant CDK4/6 inhibition. These patients experienced worse survival outcomes compared to their ineligible counterparts. These findings provide real-world historical outcome data for patients who would now be considered candidates for adjuvant ribociclib and may serve as a benchmark for evaluating outcomes following adoption of adjuvant ribociclib.",
  "abstract_shown": true,
  "affiliations": [
    "Section of Hematology and Medical Oncology, Department of Internal Medicine, King Hussein Cancer Center, Amman, 11941, Jordan",
    "School of Medicine, The University of Jordan, Amman, 11941, Jordan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Hikmat Abdel-Razeq",
      "orcid": "0000-0003-2833-6051"
    },
    {
      "affs": [
        0
      ],
      "name": "Malek Horani",
      "orcid": "0009-0006-3662-6242"
    },
    {
      "affs": [
        0
      ],
      "name": "Faris Tamimi",
      "orcid": "0000-0002-9337-6618"
    },
    {
      "affs": [
        0
      ],
      "name": "Tamer Al-Batsh"
    },
    {
      "affs": [
        0
      ],
      "name": "Osama El Khatib",
      "orcid": "0000-0002-3697-7708"
    },
    {
      "affs": [
        0
      ],
      "name": "Yosra Almasri"
    },
    {
      "affs": [
        0
      ],
      "name": "Ameed Sameer Ghanem",
      "orcid": "0009-0008-2700-6425"
    },
    {
      "affs": [
        0
      ],
      "name": "Qutaiba Jawarneh",
      "orcid": "0009-0009-0308-6405"
    },
    {
      "affs": [
        0
      ],
      "name": "Maram Ismat Al-yag’oub"
    },
    {
      "affs": [
        0
      ],
      "name": "Adel Yousef Jaffal",
      "orcid": "0009-0003-2531-7370"
    },
    {
      "affs": [
        0
      ],
      "name": "Rnad Khader"
    },
    {
      "affs": [
        0
      ],
      "name": "Asala Alanani"
    },
    {
      "affs": [
        0
      ],
      "name": "Baha Sharaf",
      "orcid": "0000-0003-4368-1224"
    },
    {
      "affs": [
        0
      ],
      "name": "Maryam El-Atrash"
    },
    {
      "affs": [
        0
      ],
      "name": "Tala Abuhamdah"
    },
    {
      "affs": [
        0
      ],
      "name": "Ayat Taqash",
      "orcid": "0000-0002-1046-8622"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7208q5aw8wn4n.bib",
  "cited_by": 0,
  "doi": "10.2147/dddt.s637101",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13709977/",
  "id": "7208q5aw8wn4n",
  "issns": [
    "1177-8881"
  ],
  "landing_url": "https://doi.org/10.2147/dddt.s637101",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2740|Advanced Breast Cancer Therapies"
    ]
  ],
  "openalex": "W7223188353",
  "pdf_url": "https://www.dovepress.com/article/download/121220",
  "pmcid": "PMC13709977",
  "pmid": "42947686",
  "published": "2026-10-22",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/7208q5aw8wn4n.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:02Z",
      "native_id": "PMC13709977",
      "source": "pmc",
      "url": "https://doi.org/10.2147/dddt.s637101"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Advanced Breast Cancer Therapies",
      "subfield": "general"
    }
  ],
  "title": "Treatment Outcomes of Patients with Early-Stage Breast Cancer Meeting NATALEE Eligibility Criteria. A Real-World Cohort Study",
  "title_text": "Treatment Outcomes of Patients with Early-Stage Breast Cancer Meeting NATALEE Eligibility Criteria. A Real-World Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:02Z",
  "url": "https://research.draconitic.com/paper/7208q5aw8wn4n",
  "venue": "Drug Design, Development and Therapy",
  "versions": []
}