Guidelines

Natalee

A

AT

Substantial benefit

Curative intent  
Evaluated outcome:

DFS, OS or pCR

Adapted from ESMO Scorecards. 2026.^(1,2)

* In EBC: Grade A: Improvements in DFS alone (primary endpoint) HR ≤0.65 AND absolute gain ≥3% in studies without mature survival data.⁽³⁾

ESMO-MCBS scores are based on peer-reviewed clinical trial reports. They are generated using a validated standard methodology and are reviewed by a team of clinicians and statisticians before publication. The ESMO-MCBS facilitates clinical decision-making by rating clinically meaningful benefit of cancer medicines from published data. ESMO-MCBS scores should be interpreted in the context of an evolving treatment landscape, in connection with clinical practice guidelines.^(3,4)

In EBC:
The first and only CDK4/6i for N0 high-risk* and N+ EBC⁽¹⁾

In ABC:
The only CDK4/6i with a Category 1 rating in combination with both AI or fulvestrant⁽¹⁾

* N0, T3–4 disease or N0, T2 Grade 3 or Grade 2 disease with additional risk factors, such as Ki-67 score ≥20% or defined as an Oncotype DX Breast Recurrence Score of ≥26, or Prosigna/PAM50, MammaPrint, or EndoPredictEPclinhigh-risk scores.⁽²⁾

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