Dr Dennis Slamon on What Sets the NATALEE Trial Apart From Other Breast Cancer Studies

Dennis Slamon, MD, PhD, UCLA Health, lead investigator on the NATALEE trial of ribociclib plus hormonal therapy in hormone receptor–positive, HER2-negative early-stage breast cancer (NCT03701334), discussed the study's broad population and potential payer reactions. Interim findings from the study were presented at the 2023 Annual Meeting of the American Society of Clinical Oncology.

Transcript

What elements make this trial different from other studies in early breast cancer?

The biggest element that differentiates this trial from other trials is the inclusion of a broader population of these patients—in other words, patients with node-negative disease, patients with lower-stage disease. Some of the trials were really focused on high-risk patients. Are those the only patients that can benefit from the drug? Patients who have lower risk but are still at risk for having—as I said, 30% will have a recurrence 2 or 3 decades out—can those patients be benefited? Well, the trial is including those patients in the study.

If this treatment approach is used in real-world settings, do you feel payers will see value in the improved safety profile vs the longer treatment duration?

My sense is that it all depends on the data. If the data are strong enough and there is a survival advantage, I think payers would be hard pressed not to provide reimbursement for the drug. Clearly, drug pricing is important. And it should be rational in terms of what the drug costs are. But if it provides real value and really makes an impact both on quality of life and life itself, I think those drugs should be paid for.