Deciding whether to go on abemaciclib (brand name Verzenio)

I believe side effects management should be a conversation before you take your first treatment. Everyone has some side effects from chemo, ranging from very mild to very awful.
Asking your doctor or oncology nurse about what you should do if you have problems and who do you call if you need help is a good opener for that conversation. Sometimes it is helpful to have a list of questions, so that after the doctor tells you the plan, you can check and make sure all of your questions are answered.
Sometimes fighting cancer requires us to take strong drugs and we need to know that we can rely on our doctors if we have a problem.
Are you comfortable having this conversation with your doctor?

@lynelyn I agree with @auntieoakley however I'm wondering if you might have had a conversation with your oncologist or oncology nurse already. Here is information about this new treatment that appears very promising.
https://www.breastcancer.org/research-news/verzenio-approved-to-treat-early-hr-pos-bc-with-high-risk-of-recurrence
Are you wondering what side effects anyone here has had? Could you clarify so we can be most helpful to you?

I'm on Verzenio for the past 6 months (for MBC). I had diarrhea/urgent need to go at the beginning but it went away after 6 weeks or so. I guess the body adapts. I try to take it 1 hr before any meals and slowly drink a glass of cold water when taking it, pretty much sip by sip. I think it helped to take it well before any meals and other meds -if any. Just writing to let you know that even if you experience some side effects at the beginning , at least in my case, they went away.

Size of tumor, nodal involvement, and even tumor Grade have much more influence on the risk of recurrence. Stage III are by definition larger tumors; 4-positive nodes is is what's contributing to state III over II (stage II nodal involvement is <4). If you take a look at figure 1 (Hazard of recurrence among women after primary breast cancer treatment--a 10-year follow-up using data from SEER-Medicare by Cheng published in 2012)

What this is showing you is that Stage III disease (which is larger tumor and more nodal involvement) has a higher risk of recurrence, particularly in the first 2-3 years. The peak is higher comparatively to Stage I and stage II. Adding abemaciclib is intended to lower that peak...lower the risk of cancer coming back when that risk is the highest. Technically Verzenio is not FDA approved for patients with Ki-67 <20%, at least for now. However the major guidelines for practice (NCCN, ASCO) endorse adding abemaciclib based on the available data shown to reduce recurrence, even in patients with a low ki-67 score.

So based on the phase III data, any patient with Stage III disease (A,B,C) is a strong candidate for abemaciclib with endocrine therapy as adjuvant treatment. Stage II patients that are node positive but have 1-3 nodes, are candidates if they have large tumors (5cm or more), have grade 3 disease (high grade), or both of these factors.

Hope this helps.

Advanced breast cancer is metastatic (Stage IV); meaning it has spread at least to bone, or liver, or brain, or lungs, or a combination. Stage IIIA is still considered early stage; and technically IIIB and IIIC is known as locally advanced.

Ki-67 is not the bigger predicter of breast cancer recurrence, but it is one of many factors. Size of tumor, nodal involvement, and even tumor Grade have much more influence on the risk of recurrence. Stage III are by definition larger tumors; 4-positive nodes is what's contributing to stage III over II (stage II nodal involvement is <4).

If you take a look at figure 1 (Hazard of recurrence among women after primary breast cancer treatment–a 10-year follow-up using data from SEER-Medicare by Cheng published in 2012)

What this is showing you is that Stage III disease (which is larger tumor and more nodal involvement) has a higher risk of recurrence, particularly in the first 2-3 years. The peak is higher comparatively to Stage I and stage II. What your doctor is suggesting is to lower that peak…lower the risk of cancer coming back when that risk is the highest. Technically Verzenio/abemaciclib is not FDA approved for patients with Ki-67 <20%, like you. However the major guidelines for practice (NCCN, ASCO) all endorse adding abemaciclib based on the available data published data shown to reduce recurrence, even in patients with a low ki-67 score but stage III disease like yourself.

Hope this helps.

I was on Verzenio for 18 mos along with Arimidex for my first drugs when I was identified as being MBC. I did not do any chemo or radiation after my double mastectomy but instead did those meds. I had diarrhea/urgent need to go for about 1 week and then very infrequently over the remaining months. I pivoted to a much healthier diet with more fruits and veggies, blander food and protein shakes. You will be given Imodium to counteract the diarrhea but i didn't like the swing between the 2 meds. I will tell you also that my hair thinned out and my nails became more brittle - could be either of my 2 meds or both together. I started taking Hair, Skin and Nail gummies which is a lot of biotin, and I believed that helped...even through my later chemo. My docs were very pleased that i had a great 18 mos and I agreed. I went about my normal busy routine. While my docs and I hopeful were hopeful that i would be on it longer, my MBC is weird because it was initially in my skin which is our largest organ. The Verzenip completely took care of it there and it did not come back there when my MBC went to other areas. But the good news is there are other great drugs we pivoted to after a bit of a bumpy road and now I am back in remission again. They told me to think of my cancer as a chronic condition. Three years later I am still busy and I keep moving. Good luck!!

I've tried unsuccessfully navigate the NCCN website after my oncologist gave me a print -out from to no avail. I had a lumpectomy for a Stage 1A tumor last year and would like to read further about both NCCN and ASCO care recommendations. If you have the URLs for those, I would appreciate looking at both of them. [If this is off-topic, private messaging them would be fine.] Thanks!

Thank you. Yes. As the reduction in recurrence benefit is so good, I’m resolved to work through side effects with my oncology team. I am specifically interested in anecdotal info anyone might have on how long it took them to manage initial side effects (ie. diarrhea, fatigue.)

Thank you! I hadn’t considered spacing it out from meds.

Thank you for sharing your experience. I’m only two days into my initial dose set. It’s good to hear how you managed the side effects. I’m still adjusting to the idea of ongoing treatment, but am so thankful it’s available!