What is Verzenio and How Does It Work?

Verzenio (abemaciclib) belongs to a class of medications called cyclin-dependent kinase (CDK) 4/6 inhibitors. Approved by the FDA in 2017, this oral tablet is specifically designed to treat hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer that has either spread to other parts of the body or cannot be removed by surgery.

At its core, Verzenio works by interrupting the cell division process that cancer cells rely on to grow and spread. By targeting and blocking the CDK4 and CDK6 proteins, it helps stop cancer cells from dividing uncontrollably. What makes Verzenio distinct from other CDK4/6 inhibitors is its continuous dosing schedule and its ability to cross the blood-brain barrier, which may offer advantages for certain patients.

Treatment Protocols and Administration

Verzenio is prescribed in several different treatment scenarios. It can be used in combination with an aromatase inhibitor as initial therapy for postmenopausal women with advanced or metastatic breast cancer. It may also be combined with fulvestrant for women whose disease has progressed after endocrine therapy. Additionally, Verzenio can be used as a standalone treatment for patients who have received prior endocrine therapy and chemotherapy.

The standard dosing for Verzenio is typically 150 mg taken orally twice daily when used in combination with other therapies, or 200 mg twice daily when used alone. Unlike some other cancer medications that follow a cyclical schedule, Verzenio is taken continuously. This continuous inhibition of CDK4/6 proteins may provide more consistent control of cancer cell growth. Patients are advised to take Verzenio at approximately the same times each day, with or without food, and to swallow the tablets whole without crushing or splitting them.

Comparison of CDK4/6 Inhibitor Treatments

When considering treatment options, it's helpful to understand how Verzenio compares to other medications in the same class. Currently, there are three FDA-approved CDK4/6 inhibitors available for breast cancer treatment:

  • Verzenio (abemaciclib) by Eli Lilly: Taken twice daily continuously, with distinct side effect profile including diarrhea
  • Ibrance (palbociclib) by Pfizer: Taken once daily for 21 days followed by 7 days off
  • Kisqali (ribociclib) by Novartis: Also follows a 21-day on, 7-day off schedule

Each medication has shown effectiveness in clinical trials, but they differ in dosing schedules, side effect profiles, and specific indications. Verzenio is unique in its continuous dosing regimen and has shown particular efficacy in certain patient populations, including those with visceral disease (cancer that has spread to internal organs). Your oncologist will consider your specific cancer characteristics, overall health, and potential drug interactions when recommending which CDK4/6 inhibitor might work best for you.

Benefits and Potential Side Effects

Clinical trials have demonstrated significant benefits of Verzenio treatment. The MONARCH trials showed that Verzenio, when added to standard endocrine therapy, substantially improved progression-free survival in patients with HR+/HER2- advanced breast cancer. The monarchE trial also showed its benefit in reducing the risk of recurrence in early breast cancer with high-risk features after completion of primary therapy.

However, like all medications, Verzenio comes with potential side effects that patients should be aware of. The most common side effect is diarrhea, which occurs in a majority of patients but can often be managed with anti-diarrheal medications. Other common side effects include:

  • Low white blood cell counts (neutropenia)
  • Fatigue
  • Nausea
  • Abdominal pain
  • Decreased appetite

More serious but less common side effects can include liver problems, blood clots, and lung inflammation. Regular blood tests are typically conducted to monitor for these potential issues. The FDA maintains updated safety information about Verzenio, and patients should discuss any concerns with their healthcare provider. Many side effects can be managed with supportive care, dose adjustments, or temporary treatment interruptions.

Cost and Access Considerations

As with many targeted cancer therapies, the cost of Verzenio treatment can be substantial. Without insurance, the monthly cost can exceed several thousand dollars. However, multiple options exist to help patients access this medication.

Eli Lilly's patient assistance program offers support for eligible patients who cannot afford their medication. Additionally, commercial insurance plans, Medicare Part D, and Medicaid may provide coverage, though co-pays and deductibles vary significantly. Many patients also qualify for co-pay assistance programs through either the manufacturer or non-profit organizations.

When considering Verzenio treatment, it's advisable to speak with both your healthcare provider and insurance company about coverage options. Many cancer centers also have financial counselors or patient navigators who can help identify assistance programs. The American Cancer Society and other patient advocacy organizations provide resources to help navigate the financial aspects of cancer treatment.

Conclusion

Verzenio represents an important advancement in the treatment of HR+/HER2- breast cancer, offering hope to patients with both metastatic disease and those at high risk of recurrence after primary treatment. While considering this treatment option, patients should work closely with their oncology team to understand the potential benefits and risks based on their specific situation. With proper management of side effects and utilization of available financial assistance programs, Verzenio can be an accessible treatment option for many patients. As research continues, the role of CDK4/6 inhibitors like Verzenio may expand, potentially offering benefit to even more patients facing breast cancer.

Citations

This content was written by AI and reviewed by a human for quality and compliance.