Ribociclib + endocrine therapy · metastatic
The usual metastatic starting dose is ribociclib 600 mg once daily on Days 1–21 followed by Days 22–28 off. Continue the prescribed AI daily or fulvestrant on its own injection schedule; add ovarian suppression when indicated. Continue while beneficial and tolerated.
Treatment and monitoring over time
Columns show sequence and general intervals, not equal periods or booked appointments. The team confirms who arranges each test, who reviews results and who authorises treatment or restart.
| Check | Before first dose | Cycles 1–2 | Cycles 3–6 | Later treatment | Completion / change |
|---|---|---|---|---|---|
| Ribociclib and endocrine partner | Confirm metastatic 600 mg / AI or fulvestrant plan | Days 1–21 on; Days 22–28 off; fulvestrant loading visits if chosen | Repeat if cleared; endocrine partner continues | While beneficial and tolerated | Review endocrine continuation separately |
| Blood counts / renal / liver | Baseline profiles | Every two weeks in both cycles | Before each cycle | As clinically indicated; more often if abnormal | Follow abnormalities before restart or after stopping |
| ECG / heart rhythm | Baseline ECG; check QTcF eligibility | Repeat around cycle 1 Day 14 | Further ECG when clinically indicated | Repeat for symptoms, QT change or interacting medicines | No automatic restart after a QT-related hold |
| Electrolytes | Potassium, calcium, magnesium and phosphorus | Before each cycle; correct abnormalities | Before each cycle through cycle 6 | As clinically indicated | Review unresolved abnormalities |
| Bone / endocrine health | Assess AI/OFS bone and menopausal risks | Support symptoms and adherence | AI/OFS and any injections follow their own plan | Repeat bone assessment according to risk | Longer endocrine and bone plan continues |
| Cancer response | Baseline disease assessment | Assess new symptoms promptly | Imaging according to consultant plan | Continue response and symptom review | Progression prompts new treatment decision |
Ribociclib + endocrine therapy · metastatic: treatment and checks
HR-positive / HER2-negative metastatic breast cancer
The usual metastatic starting dose is ribociclib 600 mg once daily on Days 1–21 followed by Days 22–28 off. Continue the prescribed AI daily or fulvestrant on its own injection schedule; add ovarian suppression when indicated. Continue while beneficial and tolerated.
On a small screen, swipe the map sideways. The checks below give the same timing in words.
| Care / check | Before first dose | Cycles 1–2 | Cycles 3–6 | Later treatment | Completion / change |
|---|---|---|---|---|---|
| Ribociclib and endocrine partnerNCCP 00525 · SMPC | Confirm metastatic 600 mg / AI or fulvestrant plan | Days 1–21 on; Days 22–28 off; fulvestrant loading visits if chosen | Repeat if cleared; endocrine partner continues | While beneficial and tolerated | Review endocrine continuation separately |
| Blood counts / renal / liverNCCP 00525 · SMPC | Baseline profiles | Every two weeks in both cycles | Before each cycle | As clinically indicated; more often if abnormal | Follow abnormalities before restart or after stopping |
| ECG / heart rhythmNCCP 00525 · SMPC | Baseline ECG; check QTcF eligibility | Repeat around cycle 1 Day 14 | Further ECG when clinically indicated | Repeat for symptoms, QT change or interacting medicines | No automatic restart after a QT-related hold |
| ElectrolytesNCCP 00525 · SMPC | Potassium, calcium, magnesium and phosphorus | Before each cycle; correct abnormalities | Before each cycle through cycle 6 | As clinically indicated | Review unresolved abnormalities |
| Bone / endocrine healthNCCP 00525 · SMPC | Assess AI/OFS bone and menopausal risks | Support symptoms and adherence | AI/OFS and any injections follow their own plan | Repeat bone assessment according to risk | Longer endocrine and bone plan continues |
| Cancer responseNCCP 00525 · SMPC | Baseline disease assessment | Assess new symptoms promptly | Imaging according to consultant plan | Continue response and symptom review | Progression prompts new treatment decision |
What each check is for
1Before the first doseBefore first dose
Check eligibility, organ function and the exact treatment/support plan.
Ask / act: Confirm who arranges each check and who reviews it.
Sources: NCCP 00525 · SMPC
2Early toxicity checksCycles 1–2
Important toxicity can begin before the first routine review.
Ask / act: Keep early appointments and use the agreed symptom-contact plan.
Sources: NCCP 00525 · SMPC
3Benefit, tolerability and adherenceLater treatment
Longer-term treatment still needs clinical review.
Ask / act: Ask about symptom support, results and the next decision.
Sources: NCCP 00525 · SMPC
4Completion or treatment changeCompletion / change
The targeted medicine and endocrine partner may have different stop dates.
Ask / act: Confirm each medicine and the ongoing follow-up plan.
Sources: NCCP 00525
At the next review, ask
- Which treatment phase am I in, and what happens next?
- Which test is expected next, who arranges it, and who explains the result?
- Who should I contact if an expected appointment has not arrived?
This map does not show whether a test has been ordered, booked or completed. Do not wait for a scheduled test if you develop new symptoms.