Adaptive neoadjuvant endocrine therapy screens out prime population of ribociclib intensive adjuvant therapy.

The latest data from the NATALEE trial showed the absolute 3-year invasive disease-free survival benefit was 4.9% between the experimental and control groups. That is to say, in the intermediate-risk hormone receptor positive/human epidermal growth factor receptor-2 negative subgroup, there are also some patients with primary resistance to ribociclib. These patients benefit less from ribociclib, and they are unable to gain significant benefit even with the intensive adjuvant therapy of ribociclib. Considering the drug toxicity and health economic benefits, a 3-year course of ribociclib may not be appropriate for all intermediate-risk populations. Therefore, how to screen out the prime population for intensive adjuvant therapy of ribociclib needs to worth explored. In this paper, we discussed that the adaptive neoadjuvant endocrine therapy can screen out the prime population for intensive adjuvant therapy of ribociclib.