OncoPharm Ribociclib-Tamoxifen: A Cautionary Tale
Apr 14, 2022
Explore the hidden dangers of combining ribociclib with tamoxifen, particularly the risks of QT prolongation. Uncover insights from the MONALEESA-7 study that emphasize the importance of awareness for healthcare professionals. This cautionary tale sheds light on potential drug interactions and the crucial need for patient safety in cancer treatment.
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Unexpected QTc Interaction Signal
- Ribociclib plus tamoxifen produced much larger QTc increases than either drug alone in MONALEESA-7 data.
- The combination showed ~16% with >60 ms QTc increase versus 7% for tamoxifen alone and 0% for nonsteroidal AIs.
Ribociclib Raises Tamoxifen Levels
- Ribociclib appears to roughly double tamoxifen exposure (Cmax and AUC) in patients.
- This pharmacokinetic change may explain the unexpected increase in QTc when combined.
Check Interactions Before Combining Drugs
- Do not assume two safe drugs remain safe together without data; always check for interactions.
- Perform a focused literature or label review before combining oncology drugs off-label.