Caroline Streatfield, who was diagnosed with lobular breast cancer in October 2021, shares her experiences of taking abemaciclib (Verzenio), newly approved by the National institute for Health and Care Excellence (NICE).
Following the results of the MonarchE trial, NICE has recently approved the use of abemaciclib with hormone therapy as an advjuvant therapy. Adjuvant treatment aims to reduce the risk of cancer returning after surgery.
Clinical trial evidence shows that abemaciclib with endocrine therapy in patients with hormone receptor-positive, HER2-, node-positive early-brest cancer, at high risk of recurrence, increases how long people are free of disease compared with endocrine therapy alone.
There are restrictions to who can receive this drug based on the initial trial guidelines. To take abemaciclib, your diagnosis must have at least one of these characteristics:
– you had at least 4 positive axillary (armpit) lymph nodes, or
– or you had 1-3 minimum positive axillary lymph nodes, & there is either grade 3 disease or the primary tumour is at least 5 cm.
Additionally, you can not have been on hormone therapy for longer than 12 weeks.
Caroline has had first hand experience of taking the drug as part of her lobular treatment.
“I was diagnosed with invasive lobular breast cancer in October 2021 which had spread to one lymph node. I had a mastectomy, chemotherapy, and radiotherapy.
Half way through my radiotherapy I was alerted by a Facebook posting of a new medication abemaciclib which had just been approved for use with primary breast cancer which has a high risk of recurrence. Trials suggest it can reduce recurrence by up to 30%.
The criteria for prescribing is strict, however I just met the criteria as my tumour was 55mm and I had one lymph node effected. You have to be within 12 weeks of starting hormone therapy, and luckily I had started tamoxifen 8 weeks previous.
My Breast Care Nurse arranged a quick appointment with the oncologist who confirmed that I was eligible but stated that there are some quite difficult side effects and I would have to decide if the benefit to me was worthwhile.
I decided to try abemaciclib (Verzenios ) as it was explained that it could be stopped at any time if unmanageable. I was also to change from tamoxifen to letrozole and begin monthly Zoladex injections.
You are required to have blood tests fortnightly for the first three months of abemaciclib then monthly thereafter. This is to check the effect on the kidneys and white blood cells.
The recommend starting dose is twice daily at 150mg which I took for one month. The most common side effect is diarrhoea. Luckily I did not experience this but had fatigue especially in the mornings.
My white blood cell count was then too low so I had a two week break from the medication and restarted at 100mg twice daily.My neutrophils (white blood cell count) recovered, however I have had to have a further break due to them reducing again.
I am now maintaining the treatment at 2x 100mg per day and plan to stay on the treatment for the recommended period which is two years.
I haven’t had any further side effects however
the fatigue is at a level where it would be difficult to maintain a full time job. I am lucky in that I can work part time from home.
For me the benefit of taking abemaciclib has outweighed any side effects so far. Other than the purpose of physically preventing a recurrence of my cancer I have found being on this medication has made me feel more positive mentally knowing that it is another avenue of treatment available to me.”
If you have been diagnosed recently and you have a high risk of recurrence, you can speak with your medical team to explore if abermaciclib is appropriate for you.