Non-interventional Study to Assess the Effectiveness and Safety of Ribociclib in the Adjuvant Therapy of Hormone Receptor Positive (HR+) HER2-negative Stage II and III Breast Cancer in Real Clinical Practice in Russia (ELEGANCE)

This prospective, observational, multicenter study aims at evaluating the efficacy of adjuvant ribociclib in combination with hormone therapy (aromatase inhibitor ± GnRH aginost) in various subgroups of patients with HR+HER2- stage II-III breast cancer in real clinical practice in Russia. Subgroup division will be based on the tumor grade, lymph node involvement, and the response to test hormone therapy. The study will consist of two cohorts: a prospective one with patients receiving adjuvant therapy with ribociclib combined with Aromatase inhibitors (AI), and a retrospective one with patients receiving adjuvant therapy with AI alone. Thus, both primary data collection and secondary use of data will be organized.

Study Overview

• Status: Recruiting
• Conditions: Breast Cancer
• Intervention / Treatment: Drug: Letrozole; Drug: Anastrozole; Drug: Ribociclib

• Study Type: Observational
• Enrollment (Estimated): 2766

Contacts and Locations

• Study Contact: Name: Novartis Pharmaceuticals; Phone Number: +41613241111; Email: novartis.email@novartis.com
• Study Contact Backup: Name: Novartis Pharmaceuticals

Study Locations

• Russia
  • Arkhangelsk, Russia, 163045
    • Recruiting
    • Novartis Investigative Site
  • Barnaul, Russia, 656045
    • Recruiting
    • Novartis Investigative Site
  • Bryansk, Russia, 241028
    • Recruiting
    • Novartis Investigative Site
  • Irkutsk, Russia, 664035
    • Recruiting
    • Novartis Investigative Site
  • Ivanovo, Russia, 153040
    • Recruiting
    • Novartis Investigative Site
  • Izhevsk, Russia, 426009
    • Recruiting
    • Novartis Investigative Site
  • Kemerovo, Russia, 650036
    • Recruiting
    • Novartis Investigative Site
  • Khabarovsk, Russia, 680042
    • Recruiting
    • Novartis Investigative Site
  • Khanty-Mansiysk, Russia, 628012
    • Recruiting
    • Novartis Investigative Site
  • Khimky, Russia, 121552
    • Recruiting
    • Novartis Investigative Site
  • Kirov, Russia, 610021
    • Recruiting
    • Novartis Investigative Site
  • Krasnoyarsk, Russia, 660022
    • Recruiting
    • Novartis Investigative Site
  • Moscow, Russia, 129110
    • Recruiting
    • Novartis Investigative Site
  • Moscow, Russia, 115304
    • Recruiting
    • Novartis Investigative Site
  • Moscow, Russia, 125284
    • Recruiting
    • Novartis Investigative Site
  • Moscow, Russia, 115522
    • Recruiting
    • Novartis Investigative Site
  • Moscow Region Balas, Russia, 143900
    • Recruiting
    • Novartis Investigative Site
  • Perm, Russia, 614066
    • Recruiting
    • Novartis Investigative Site
  • Pyatigorsk, Russia, 357502
    • Recruiting
    • Novartis Investigative Site
  • Rostov-on-Don, Russia, 344006
    • Recruiting
    • Novartis Investigative Site
  • Saint Petersburg, Russia, 194291
    • Recruiting
    • Novartis Investigative Site
  • Saint Petersburg, Russia, 194017
    • Recruiting
    • Novartis Investigative Site
  • Saint Petersburg, Russia, 197758
    • Recruiting
    • Novartis Investigative Site
  • Saransk, Russia, 430032
    • Recruiting
    • Novartis Investigative Site
  • Sestroretsk, Russia, 197706
    • Recruiting
    • Novartis Investigative Site
  • Tver', Russia, 170008
    • Recruiting
    • Novartis Investigative Site
  • Tyumen, Russia, 625023
    • Recruiting
    • Novartis Investigative Site
  • Ufa, Russia, 450054
    • Recruiting
    • Novartis Investigative Site
  • Vladikavkaz, Russia, 362002
    • Recruiting
    • Novartis Investigative Site
  • Vladivostok, Russia, 690105
    • Recruiting
    • Novartis Investigative Site
  • Volgograd, Russia, 400138
    • Recruiting
    • Novartis Investigative Site
  • Voronezh, Russia, 394036
    • Recruiting
    • Novartis Investigative Site
  • Yaroslavl, Russia, 150054
    • Recruiting
    • Novartis Investigative Site
  • Yekaterinburg, Russia, 620036
    • Recruiting
    • Novartis Investigative Site
  • Yuzhno-Sakhalinsk, Russia, 693010
    • Recruiting
    • Novartis Investigative Site
  • Russia
    • Kaluga, Russia, Russia, 248007
      • Recruiting
      • Novartis Investigative Site
    • Pskov, Russia, Russia, 180000
      • Recruiting
      • Novartis Investigative Site
    • Ryazan, Russia, Russia, 390011
      • Recruiting
      • Novartis Investigative Site
  • Tymen Area
    • Surgut, Tymen Area, Russia, 628402
      • Recruiting
      • Novartis Investigative Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Patients with HR+HER2- stage II-III breast cancer receiving adjuvant therapy with ribociclib combined with AI will be include in prospective cohort.

Patients with HR+HER2- stage II-III breast cancer receiving adjuvant therapy with AI alone will be included in retrospective cohort.

Description

Inclusion Criteria:

Patients from the prospective cohort of the study must meet all of the following criteria:

1. Signed and dated Informed Consent Form (ICF) not later than 28 days after the initiation of adjuvant therapy with ribociclib in combination with aromatase inhibitors (±GnRH agonists).
2. Age ≥18 years at the time of signing the ICF.
3. Histologically verified HR+ HER2-negative stage II-III breast cancer, for which radical treatment was carried out.
4. The adjuvant hormone therapy with aromatase inhibitors (±GnRH agonists) may be started not earlier than 12 months before initiation of therapy with ribociclib.
5. ECOG performance status 0-1

Patients from the retrospective cohort of the study must meet all of the following criteria:

1. Age ≥18 years at the initiation of hormone therapy.
2. Histologically verified HR+ HER2-negative stage II-III breast cancer, for which radical treatment was carried out.
3. Initiation of adjuvant hormone monotherapy with aromatase inhibitors (±GnRH agonists) in the index period from July 1, 2019 to July 1, 2020.
4. Presence of the necessary information in the source documentation.

Exclusion Criteria:

Patients enrolled in the study in prospective cohort should not meet any of the following criteria.

1. History of therapy with abemaciclib or palbociclib
2. Therapy with ribociclib in combination with AI for more than 28 days at the time of signing the Informed Consent Form
3. Active therapy for other malignant neoplasms
4. Participation in interventional clinical studies at the time of signing the Informed Consent Form

Patients enrolled in the study in retrospective cohort should not meet any of the following criteria.

1. Neoadjuvant or adjuvant therapy with CDK4/6 inhibitors
2. A history of another concomitant malignant neoplasm requiring active therapy
3. Participation in interventional clinical studies at the time of treatment for breast cancer
4. Patients experiencing a recurrence during adjuvant hormone therapy can participate if they meet the other inclusion and exclusion criteria.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Ribociclib+AI; Patients with HR+ HER2- stage II-III breast cancer receiving adjuvant ribociclib plus AI (aromatase inhibitor)	Drug: Letrozole; Aromatase inhibitor; Drug: Anastrozole; Aromatase inhibitor; Drug: Ribociclib; CDK4/6 inhibitor
Monotherapy AI; Patients with HR+ HER2- stage II-III breast cancer receiving adjuvant AI (aromatase inhibitor) monotherapy	Drug: Letrozole; Aromatase inhibitor; Drug: Anastrozole; Aromatase inhibitor

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Invasive breast cancer-free survival (IBCFS) according to the Standardized Definitions for Efficacy End Points (STEEP) criteria in a prospective cohort	IBCFS at M36, M48, and M60 according to the STEEP 2.0 criteria in a prospective cohort (defined as the time from the start of therapy to one of the listed events: ipsilateral invasive recurrence of breast cancer, locoregional invasive recurrence, distant recurrence, breast cancer-related death, death not associated with breast cancer progression, death from unknown cause, contralateral invasive recurrence of breast cancer) depending on the tumor grade (G2/G3) and the status of lymph node involvement (N0/N1/N2-3)	Months 36, 48, 60

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Invasive breast cancer-free survival in prospective and retrospective cohorts depending on the tumor grade (G2/G3) and on the status of lymph nodes involvement (N0/N1/N2-3).	IBCFS at M36, M48, and M60 according to the STEEP 2.0 criteria in prospective and retrospective cohorts (defined as the time from the start of therapy to one of the listed events: ipsilateral invasive recurrence of breast cancer, locoregional invasive recurrence, distant recurrence, breast cancer-related death, death not associated with breast cancer progression, death from unknown cause, contralateral invasive recurrence of breast cancer) depending on the tumor grade (G2/G3) and on the status of lymph nodes involvement (N0/N1/N2-3).	Months 36, 48, 60
Invasive disease-free survival (IDFS) in prospective and retrospective cohorts depending on the tumor grade (G2/G3) and on the status of lymph nodes involvement (N0/N1/N2-3).	IDFS is defined as the time from surgery until first occurrence of invasive breast cancer recurrence, distant recurrence, or death from any cause	Months 36, 48, 60
Recurrence-free survival (RFS) in the prospective and retrospective cohorts depending on the tumor grade (G2/G3) and on the status of lymph nodes involvement (N0/N1/N2-3).	Recurrence-free survival is the length of time after the treatment of the cancer ends that the patient survives without cancer symptoms.	Months 36, 48, 60
Number of doses taken relative to the total planned doses of ribociclib %	To evaluate the dose intensity of ribociclib.	Months 36
Number of participants with AEs/SAEs including those of special interest, in patients receiving ribociclib	The frequency of AE/SAE of varying severity, including those of special interest (neutropenia, elevated ALT/AST, prolonged QT interval), expressed as a percentage of the total study population receiving ribociclib	Months 3, 6, 9, 12, 24, 36
Number of patients who discontinued ribociclib for any reason, due to any AE, and due to AEs of special interest	The frequency of ribociclib discontinuation for any reason, due to any AE, and due to AEs of special interest (neutropenia, elevated ALT/AST, prolonged QT interval), expressed as a percentage of the total study population receiving ribociclib	Months 3, 6, 9, 12, 24, 36
Patients' quality of life evaluated through a questionnaire	The number (%) of patients in each response category (no problems, mild problems, moderate problems, severe problems, and extremely severe problems) according to the questionnaire scale (mobility, self-care, normal activities, pain/discomfort, anxiety/depression). The scale on 5 particular symptoms from 1 (no difficulties) to 5 (severe limitations).	Months 3, 6, 9, 12, 24, 36, 48, 60

Collaborators and Investigators

• Sponsor: Novartis Pharmaceuticals

Study record dates

Study Major Dates

• Study Start (Actual): December 3, 2025
• Primary Completion (Estimated): December 31, 2032
• Study Completion (Estimated): December 31, 2032

Study Registration Dates

• First Submitted: April 9, 2025
• First Submitted That Met QC Criteria: April 9, 2025
• First Posted (Actual): April 16, 2025

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 19, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Breast cancer
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Skin Diseases; Breast Diseases; Skin and Connective Tissue Diseases; Breast Neoplasms; Organic Chemicals; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Azoles; Nitriles; Triazoles; Letrozole; Anastrozole; ribociclib
• Other Study ID Numbers: CLEE011O1RU02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO