Use of CDK4/6 Inhibitors
- CDK4/6 inhibitors are a newer class of drugs indicated for women with hormone receptor positive metastatic breast cancer.
- The FDA approved an expanded indication for Verzenio: it now includes all adult patients, with the expanded indication including pre-/perimenopausal women when used in combination with ovarian suppression.
- It can also be used in combination with endocrine therapy (tamoxifen or an aromatase inhibitor) for the adjuvant treatment of adult patients with hormone receptor (HR)-positive, HER2-negative, node-positive, early breast cancer at high risk of recurrence.
- One of the common side effects of these medicines is a reduction in white blood cells which are part of your body’s immune system.
- Patients need to speak to their doctors to see if this is something they need to be concerned with, given the ongoing pandemic.
- These drugs have been effective in improving survival in women with this type of metastatic breast cancer
This side effect may cause some concern, says Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center in New York. "Patients may want to talk to their doctors about it since these medications could lower their white blood cell count somewhat and affect their immune system," she says.
Read More White blood cells are the ones that fight infections and are part of our immune response. "Whether or not patients should remain on these drugs is really a conversation they should be having with their doctor," says Dr. Comen.
Every Patient Is Unique
Some people with breast cancer may take CDK4/6 inhibitors for years with no negative side effect, such as any significant reduction of their white blood cell count. In that instance, physicians may feel very comfortable keeping them on the medications, especially if they are in an area where COVID-19 is less of a concern. "On the other hand, a patient may be newly diagnosed with metastatic breast cancer, and we're not sure of the exact dose they should be on, and there may be ways that the doctor can think about that or adjust the dose so that there is less concern about being immune compromised," says Dr. Comen. Related: Hopeful News for Breast Cancer: A New Drug Combination to Extend Survival TimeHowever, the good news is that CDK4/6 inhibitors clearly improve overall survival in women with metastatic breast cancer. "The reality is that most patients who have estrogen receptor positive metastatic breast cancer and are newly diagnosed, can do very well for long periods of time on these medications," says Dr. Comen.
Am I eligible for Verzenio?
Verzenio is a kinase inhibitor indicated:
- in combination with endocrine therapy (tamoxifen or an aromatase inhibitor) for the adjuvant treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-positive, early breast cancer at high risk of recurrence.
- in combination with an aromatase inhibitor as initial endocrine-based therapy for the treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer.
- in combination with fulvestrant for the treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.
- as monotherapy for the treatment of adult patients with HR-positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy and prior chemotherapy in the metastatic setting.
Questions to Ask Your Doctor
- Am I eligible to receive Verzenio?
- How will I feel during treatment?
- What are the most common side effects of Verzenio?
- What will my treatment cost?
- Will my treatment be covered by my medical insurance company?
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