Ribociclib/Kisqali with Letrozole - Any one on this combo?
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@forza Happy to hear the drug is working for you. I am going to check with my oncologist at my next appointment. Thank you for this information, Much appreciated!
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Hi everyone
I follow this thread, although I only comment sporadically, as my treatment has been Kisqali/fulvestrant. It's my first line and I've been on it for four years. I may be switching to Kisqali/letrozole in the next few weeks and would greatly appreciate your input as to side effects.
I think it would be useful to explain how I got to this point, so apologies for the long story. Between June and December, 2025, I had recurring bouts of diverticulitis and Kisqali was stopped intermittently for a total of thee months because of antibiotics. I continued on Fulvestrant the entire time. In December I resumed Kisqali at 200 mg for 2 cycles then returned to my normal dose of 400 mg. My MO ordered a Tempus test which showed a low percentage of ctDNA and no actionable mutations. My most recent scans showed 3 small bone mets (I'm bone only) and a small growth of 2mm in an existing met. Two of the mets have already been radiated and the other two have been scheduled for radiation on May 26.
My MO proposed a possible treatment change to Verzenio/fulvestrant, which I refused. I don't think my GI tract is sufficiently recovered from the damage of diverticulitis to withstand Verzenio. I also don't think Kisqali failed - it was simply removed for a long period - and I questioned why she didn't think Fulvestrant is the treatment that failed since I continued that even in the absence of Kisqali. She admitted that, in the case of mutations, there's really no way to tell which medication failed. To her credit, she agreed to discuss the possibility of a switch to Kisqali/letrozole with her colleagues. I was lucky to be able to schedule a second opinion appointment with a very well regarded MO at Johns Hopkins and saw her last week. She said that she would prefer a switch to Kisqali/letrozole rather that Verzenio/fulvestrant and said that she would send a report to my MO.
I am at a crossroads and would welcome comments and suggestions.
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@eleanora Gosh, that is a tough decision, with conflicting viewpoints. I can't really say how you should decide, but I'd go with the opinion of the top institution if it were me. Really sorry you are dealing with such anxiety and uncertainty.
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Thanks so much for your input. One of my recurring issues throughout Stage IV is that my MO, while brilliant, is relatively young ( my guess is her 40s, but at almost 76, that's young to me) and her responses at critical moments like this sound as though she's reading from a manual. No ability to "think outside the box". I'm hoping that the Johns Hopkins MO, who is much more mature, will add her expertise and creativity to the mix moving forward. At almost 76, with a good QOL, my goal is to maintain that for a few more years before I leave.
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