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Breast Cancer — SCE Medical Oncology MCQ

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HardBreast CancerBreast CancerSCE Medical Oncology

A premenopausal woman with endocrine-sensitive ER-positive HER2-negative metastatic breast cancer has no visceral crisis and is starting ribociclib with letrozole. Which additional endocrine component is required by the UK product information?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Ovarian function suppression with an LHRH agonist

Explanation lettering: D = shown as A · C = shown as B · A = shown as C · B = shown as D

E is correct. In premenopausal or perimenopausal women, ribociclib with an aromatase inhibitor is combined with an LHRH agonist to suppress ovarian oestrogen production. Letrozole alone can stimulate gonadotrophins and is not effective endocrine deprivation in a functioning ovary. Fulvestrant represents a different endocrine backbone, tamoxifen is not combined with ribociclib in the SmPC because of QT concerns, and megestrol has no cycle-break role. Surgical oophorectomy can achieve permanent suppression but is not required after three cycles; method selection should reflect patient preference and fertility goals.

Reference: Kisqali UK Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/8110/smpc