---
title: "Early Breast Cancer Guidelines for Kisqali | Kisqali®"
description: "Explore NCCN recommendations and ESMO-MCBS evidence for KISQALI® (ribociclib) in HR+/HER2− early breast cancer."
canonical_url: "https://www.kisqali.com/early-breast-cancer/guidelines"
meta:
  "og:description": "Explore NCCN recommendations and ESMO-MCBS evidence for KISQALI® (ribociclib) in HR+/HER2− early breast cancer."
  "og:title": Guidelines
---

## **Highest rated CDK4/6i in EBC**

### **Currently the only CDK4/6i scored “A” by ESMO-MCBS for HR+/**HER2– EBC** **<sup>(1,2)</sup>

**Natalee**

**Substantial benefit **

**Curative intent  ** Evaluated outcome:

DFS, OS or pCR

Adapted from ESMO Scorecards. 2026.<sup>(1,2)</sup>  
  
 \* In EBC: Grade A: Improvements in DFS alone (primary endpoint) HR ≤0.65 AND absolute gain ≥3% in studies without mature survival data.<sup>(3)</sup>  
  
 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.<sup>(3,4)</sup>

## **NCCN consensus**

### **NCCN® recommends KISQALI + NSAI as a Category 1 preferred treatment option in both HR+/HER2– ABC and EBC. **<sup>(1)</sup>

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

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

\* 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.<sup>(2)</sup>  
  
NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

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