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The CDK4\/6i ribociclib in combination with an aromatase inhibitor (AI) or fulvestrant (FUL) has demonstrated significant progression\u2010free survival (PFS) and overall survival (OS) benefits for pre\u2010 and postmenopausal aBC patients who were enrolled in the three pivotal MONALEESA trials. Following the initial approval of ribociclib in 2017, the non\u2010interventional RIBANNA study was initiated to evaluate the effectiveness and safety of ribociclib plus AI\/FUL therapy among patients with aBC in a real\u2010world setting. Two additional treatment cohorts (endocrine monotherapy [ET] and chemotherapy [CT]) were included to extend the knowledge about current aBC treatments. A total of 2567 patients were enrolled in 279 study centers, of whom 1852 were treated with ribociclib+AI\/FUL, 183 were treated with ET, and 139 were treated with CT, who were available for effectiveness analyses. Median PFS (mPFS) and median OS (mOS) on first\u2010line treatment with ribociclib+AI\/FUL were 35.0 and 76.0\u2009months, respectively. Adjustment for differences in demographic and baseline characteristics resulted in a longer mPFS on ribociclib+AI\/FUL (34.7\u2009months) compared to ET (26.4\u2009months) or CT (19.2\u2009months). Adverse events (AEs) on ribociclib were consistent with those seen in the pivotal trials, and no new safety signals were observed. The RIBANNA study confirmed the PFS and OS benefit seen in the MONALEESA trials. Together with the safety data, this large real\u2010world dataset supports the favorable risk\/benefit profile of ribociclib in large scale patient populations.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70397","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:20:32Z","timestamp":1773030032000},"page":"210-223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real\u2010world progression\u2010free survival and overall survival in patients with\n                    <scp>HR<\/scp>\n                    <sup>+<\/sup>\n                    \/\n                    <scp>HER2<\/scp>\n                    <sup>\u2212<\/sup>\n                    advanced breast cancer treated in first\u2010line with ribociclib, endocrine monotherapy or chemotherapy: Results from the observational\n                    <scp>RIBANNA<\/scp>\n                    study"],"prefix":"10.1002","volume":"159","author":[{"given":"Peter A.","family":"Fasching","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital Erlangen  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosima","family":"Brucker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Klinikum N\u00fcrnberg Nord, Paracelsus Medical University  N\u00fcrnberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3814-8775","authenticated-orcid":false,"given":"Thomas","family":"Decker","sequence":"additional","affiliation":[{"name":"Oncology Ravensburg  Ravensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Engel","sequence":"additional","affiliation":[{"name":"Winicker Norimed GmbH  N\u00fcrnberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"G\u00f6hler","sequence":"additional","affiliation":[{"name":"Onkozentrum Dresden\/Freiberg  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Jackisch","sequence":"additional","affiliation":[{"name":"Evangelische Kliniken Essen Mitte gGmbH (KEM)  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Janssen","sequence":"additional","affiliation":[{"name":"Medizinische Studiengesellschaft Nord\u2010West GmbH  Westerstede Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"K\u00f6hler","sequence":"additional","affiliation":[{"name":"Practice for Hematology and Oncology  Langen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"L\u00fcdtke\u2010Heckenkamp","sequence":"additional","affiliation":[{"name":"Department of Oncology and Hematology Niels\u2010Stensen Kliniken  Georgsmarienh\u00fctte Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"L\u00fcftner","sequence":"additional","affiliation":[{"name":"Immanuel Hospital M\u00e4rkische Schweiz, Buckow &amp; 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