Join Us

We are 220,444 members in 84 forums discussing 161,934 topics.

Help with Abbreviations

Topic: Abemaciclib Verzenio

Forum: Stage IV/Metastatic Breast Cancer ONLY —

Please respect that this forum is for members with stage IV/metastatic breast cancer only. There is a separate forum for caregivers and friends: Caring for Someone with Stage 4 or Mets.

Metastatic breast cancer (MBC; also called stage IV) is breast cancer that has spread to other parts of the body, most commonly the bones, liver, brain, or lungs. Metastatic breast cancer can be treated but not cured. Metastatic disease is NOT hopeless. There are a wide variety of treatment options for metastatic breast cancer, and new medicines are being tested every day. More and more people are living life to the fullest while being treated for metastatic breast cancer.

Note: Please contact your doctor for any specific concerns about symptoms you are experiencing or your course of treatment.

Learn more about living with MBC.

Intro medically reviewed by: Brian Wojciechowski, M.D.
Last review date: November 22, 2020

Posted on: Jan 1, 2018 05:03AM - edited Jun 18, 2018 12:19AM by zarovka

zarovka wrote:

Luckylegs and friends on Abemaciclib - I am bumping the Verzenio discussion in the hopes that more people have started abemaciclib. We need to get a community going. I have not started abemaciclib but it is on my short list. Like many I am very interested in how people do on this treatment do, both as a monotherapy and in combination with hormone suppression and other treatment. I am hoping that this thread can capture the experience of everyone on Abemaciclib in whatever combination. This is a very important treatment option that we all need to be evaluating.

I would expect more people on the drug given the significant advantages of abemaciclib over the first generation CDK 4/6 inhibitors. However, the FDA has approved abemaciclib for only limited indications. We have not established its use as a first line treatment nor as something to switch to from Ibrance. At the same time, they haven't made it clear that the drug can and should be used after Ibrance. As a result, the setting for using abemaciclib is supremely unclear.

I believe abemaciclib can be used either instead of or after palbo/ribo depending on whether you view abemiciclib as another class of drug or the same class of drug with significant improvement. One can make arguments for either strategy. If you've already done palbo/ribo, it is certainly worth trying abemaciclib. If you haven't done palbo/ribo, the current guideline that you start with the first generation CDK 4/6 is reasonable, but not necessary IMO. A lot depends on the side effect profile you can tolerate the best as the drugs have significant differences in side effects and also whether you are at risk of brain mets. Abemaciclib is better at crossing the blood brain barrier.

The following summary of abemaciclib data taken from a thread started by Constantine on Inspire. I moved his entire discussion from three posts because it's that good. Thank you Constantine.

ABEMACICLIB (VERZENIO)
Preliminary data from a phase I study of abemaciclib [SABCS 2014] in patients with five different tumor types including HR-positive metastatic breast cancer, with I note a median of seven prior systemic therapies (outliers out to 11 lines) found an objective response rate of 19% and a disease control rate (including stable disease (SD) under RECIST definition of >24 weeks of ) of 81% for HR-positive MBC patients. This Phase I study was expanded to evaluate abemaciclib plus fulvestrant in HR-positive MBC [ASCO 2014.] with patients having a median of four prior systemic therapies (and outliers out to the eight line), finding an objective response rate of 62% confirmed PRs.

A subsequent Phase I study [Tolaney et al, J Clin Oncol 2015;33(Suppl 1).] of abemaciclib in combination with different endocrine therapies for HR-positive MBC (median lines of treatment = 3, with outliers out to 8) demonstrated a disease control rate (CR + PR + SD) was 67% for those on abemaciclib + AI therapy, and 75% for those on abemaciclib + tamoxifen.

The phase II MONARCH-1 trial evaluated abemaciclib MONOTHERAPY in HR-positive, HER2-negative MBC patients with a median of 3 lines of prior therapy for advanced disease, including a median of 2 lines of chemotherapy (as opposed to endocrine or biological therapy) for advanced disease, yielding an objective response rate (ORR) of 17.4% and a clinical benefit rate (CBR) of 42.4%.

What's important to remember about MONARCH-1 is that many women in the study had already received multiple lines of endocrine treatment (median 3 - 5 previous lines in the metastatic setting, with outliers beyond that), developed resistance and were refractory to all of these treatments, AND progressed, many of whom also received chemotherapy, and these results were for MONOTHERAPY in a heavily pretreated population, which as I determined through examination of historical controls with any other agent achieves at best only 10 to 20% clinical benefit rates - half of that achieved by single-agent abemaciclib, and with responses of short duration.

Hence, the collective results of these trial, including MONARCH 1 (MONARCH-2 (with letrozole) and MONARCH-3 (with fulvestrant) are exceptionally exciting breakthrough in breast cancer therapeutics.

BREAKTHROUGH SURVIVAL
In addition, for me, the overall survival (OS) of these heavily pretreated MBC patients was 17 months, and that compares to historical control I review from all clinical trials to date, as significantly better than other survival results, which are usually are at best 13 months. Thus, consider that for the current champ, eribulin chemotherapy in this setting, the EMBRACE trial achieved a median overall survival (OS) was 13 months, we clearly have here a major advance and improvement in overall survival in the highly challenging later-line settings (past at least 3 lines of therapy).

HIGH TOLERABILITY
The major limiting constraint with all CDK4/6 inhibitors to date, like palbociclib (Ibrance), is their most common adverse effect, that of myelotoxicity via neutropenia (low WBC neutrophils), with palbociclib (Ibrance inducing some degree of neutropenia in over half of women on it, with associated dose interruptions and sometimes dose reductions, a toxicity that so fat from the available data seems to also afflict ribociclib.
But abemaciclib (Verzenio) evades a good deal of this because although strictly a CDK4/6 inhibitor, it is more specific in inhibiting CDK4, that is it is CDK4-selective, and myelotoxicity including neutropenia is primarily associated with CDK6, making the incidence of neutropenia on abemaciclib significantly lower and more manageable.

CLINICAL LESSONS ON ABEMACICLIB (VERZENIO)
And unlike palbociclib (Ibrance):

1. abemaciclib has strong single-agent activity in HR–positive MBC,
2. has durable response in later line settings,
3. a good tolerability profile with reduced neutropenia, and
4. to date the highest OS in these challenging heavily pretreated settings of any oncotherapeutic agent, whether endocrine therapy, chemotherapy, or biological therapy.

SOME NUANCES
1. The ESMO-reported MONARCH 3 Trial found an response rate of 48.2% for all patients, BUT for the subgroup of patients with measurable disease, a response rate (ORR) of 59.2%, these being the highest ever response rates achieved to date for ANY endocrine therapy in breast cancer.
2. And although data needs to mature further for survival outcomes, it is anticipated based on exploratory analyses that PFS will weigh in at an improvement of close to 12 months, again an extraordinary gain.
3. In addition, Verzenio was most effective in challenging populations like those with visceral metastases (especially liver) and those with rapidly recurrent (short disease-free-interval (DFS)) patients.
4. Finally, 16 patients across two of the three MONARCH trials were NED (complete response (CR)), likely to increase once the MONARCH-3 data matures, more still I anticipate when results are reported from the MONARCH PLUS and other trials.

DIARRHEA AND ITS MANAGEMENT
To put the adverse events into a bit of perspective, although it is true that with Verzenio, all-grade diarrhea was between 86 - 90%, yet serious (Grade 3+) incidence was 13 - 20% but this is aggregated across the trials, and note further that diarrhea incidence is concentrated during the first month, and more narrowly the MTO (median time to onset) of the first diarrhea event was 6 days, lasting a median duration of just 6 days for Grade 3. Furthermore, for the most recent MONARCH-3 RCT, grade 4 diarrhea was zero, and grade 3 diarrhea was just 9.5%.

An aggressive proactive regimen of:

- high-dose loperamide/Imodium (4 mg but NOT ever de-escalated down to 2mg (and up to 16 -32 mg daily);
- "Big Pink" (Petpto Bismol Extra Strength) used in "priming" mode (started on day 4 and also used for immediate relief during loperamide dosing;
- budesonide (Symbicort) for recalcitrant cases;
PLUS "adjunct interventions:
- high-dose probiotic (28 billion microorganism count in two divided doses), and
- electrolyte powder (most of the refractory diarrhea was analyzed to be secondary to disturbed microflora and electrolyte imbalances)
- at least 12 8 oz glasses of fluid daily, 8 of which should be electrolyte-enhanced

brought the rate of diarrhea-related drug omission or dose reduction down from 22% (MONARCH 1 and 2) to under 1 - 2% in the cohorts run by my research teams in India and the Middle East.
NOTE: We found that the adjunct interventions of Big Pink, high-dose probiotic, electrolyte rebalancing, and assured fluid intake were at least important as the conventional agents, and in cases that seem intractable, converted to success, given that therapy-driven diarrhea inevitably causes GI tract flora, and electrolyte, imbalances, aggravated by inadequate hydration. Also critical was "through-and-through" loperamide dosing: 4 mg at each episode, but NOT de-escalating - as current protocols do - down to 2 mg after first (that de-escalation regimen we found indifferently effective, with large numbers of failures.

And although not reported to date, I note that in the MONARCH 3 trials the incidence of ANY grade diarrhea dropped to just 2% (courtesy of data provided by Levi Garraway at Lilly).

ACTIVITY IN LOBULAR CARCINOMA
The trials largely fail to report to date differential invasive-type stats, but the impression from conversations with some principals is that lobular breast cancer subjects are unlikely to experience significant decrement, and I also extrapolate from some hints surrounding the PELOPS (Palbociclib and Endocrine Therapy for LObular Breast Cancer Preoperative Study) Trial another CDK4/6 inhibitor palbociclib (Ibrance), as well as from some molecular considerations (the p27 gene is a key regulator of certain types of progression (G1 to S-phase) and it appears that lobular carcinomas tend to have higher p27 which in a complex way under contextual effects can have either positive or negative effects on phase progression), but we have to await sub-group analysis to report on this issue explicitly. I am cautiously confidant of little differential outcome, which I think may be confirmed across the general class of CDK inhibitors. In addition, both the lobular and the ductal groups appear to have benefited from the addition of palbociclib (Ibrance) in the PALOMA-/TRIO-18 Trial, but I note that the difference observed in PFS in that trial is likely to be an artificial artifact of the small patient in the subgroup with lobular carcinoma arm (n = 18/19) compared to n = 117 in the ductal subgroup, so this is a small sample size effect not a robust finding, an impression in agreement with that of the principal investigators (Richard Finn and UCLA and colleagues). As we learn more about lobular BC and abemaciclib in particular, I will offer further clarifications.

DEGREE OF DIFFERENCE - IBRANCE v VERZENIO
Given the dramatic 14-fold (!) greater CDK4 activity in abemaciclib (Verzenio) compared to palbociclib (Ibrance) and ribociclib (Kisqali), as MONARCH 3 lead author Angelo Di Leo has established and noted in interview, and other consequent fundamental molecular pathway differences, I view these as only shared-class (CDK), but therapeutically distinct, agents, more like the difference between third-generation capecitabine (Xeloda) versus first-generation 5-FU although these are both fluoropyrimidines.

So: More different than same as witness also the high degree of relative invariance of efficacy and durable response in later-line treatments for Verzenio compared to that of Ibrance (see my original posting, above). These differences are sufficient warrant for me to classify palbociclib (Ibrance) as a first-generation CDK inhibitor, and abemaciclib (Verzenio) as a second-generation CDK inhibitor. The devil - as always - is in the details.

CNS (BRAIN) ACTIVITY
We have preclinical data [Raub et al. Drug Metab Dispos. 2015] of the cross-BBB (blood-brain barrier) capability of Verzenio, as witness the remarkable benefit in GBM (glioblastoma, being even non-inferior to temozolomide (TMZ), the standard of care in cross-BBB activity, and this although not a human clinical, was an in vivo, not just in vitro, study. And the Dana-Farber JPBO human clinical trial (I3Y-MC-JPBO) under Sara Tolaney is investigating single-agent abemaciclib in patients with ER+/HER2+ brain metastases, where I fully expect clinically relevant CNS benefit to be confirmed, with first phase interim results reported in June at ASCO 2017 showing 2 patients (8.7%) out of 23 having confirmed partial response (PR).

I should point out that there has been some provisional data on palbociclib (Ibrance) having potential cross-BBB activity in brain metastasis, but I hasten to note that strong in vivo data show a 10-fold greater cross-BBB activity for abemaciclib than palbociclib, with abemaciclib brain levels being more efficient at substantially lower doses than palbociclib and also active for longer duration, and finally abemaciclib was active as monotherapy, palbociclib was not.

Finally, as to leptomeningeal metastases, no explicit data bears on this question directly, but as to date all agents active in brain metastases have also been active in leptomeningeal metastases, activity would be expected.

THE ISSUE OF SWITCHING
It remains an open question whether patients who have progressed on or after another CDK inhibitor like palbociclib (Ibrance) may derive significant benefit from continuance of CDK4/6 inhibition by using a following CDK inhibitor like abemaciclib (Verzenio), with many in-progress trials like TRINITI-120 (and NCT0185719319 and NCT0263204521, among others) exploring the issue. But there is some plausible extrapolation from some preclinical data which has suggested non–cross-resistance among CDK4/6 inhibitors. A Barts Cancer Institute study reported at SABCS 2016 found that some palbociclib(Ibrance)- and ribociclib(Kisqali)-resistant cell clones were sensitive to abemaciclib (Verzenio).

For patients now on Ibrance (or Kisqali) but who have NOT PROGRESSED , is it motivated to switch to abemaciclib (Verzenio)? This is an issue that needs to be thrashed about candidly with your oncology team and is a highly individual decision, but my own sense at this time is that it may be more optimal in the long run to stay the course, and consider abemaciclib (Verzenio) for recourse upon progression either off-label until the FDA expands its approval, or on one of the many abemaciclib (Verzenio) clinical trials available.

I would however entertain some specialized exceptions in which a switch now, off of Ibrance or Kisqali, onto abemaciclib (Verzenio), might be motivated; for example:

1. If a patient is experiencing repeated difficult-to-manage neutropenia, occasioning multiple drug interruptions or reductions (neutropenia being dramatically less with abemaciclib (Verzenio)), but the patient must weigh the associated countervailing issue of higher incidence - but still manageable I would argue - diarrhea on abemaciclib (Verzenio).
2. If a patient is in advanced later-line setting (say, more than 5 to 7 lines or so of treatment in the metastatic setting already completed), where it is suspected that abemaciclib (Verzenio) may be somewhat more consistent and durable in response and benefit in such challenging contexts. This is a difficult one to judgment-call, and I would tend to want to weigh each patient's circumstance and their complex treatment history and individual pathology to assist in the decision, since we have no hard data to be dispositive on this decision.

Yes, these are arguable and have to be intensively debated (as in a tumor board setting), but they are not wholly unreasonable. Outside of these exceptions, however, I do not see sufficient motivation to prematurely abandon Ibrance or Kisqali, as these have strong track records of efficacy and should be push to progression.

FDA APPROVAL

Abemaciclib is currently approved ...
1. as combination therapy with fulvestrant (Faslodex) for the treatment of women with HR+/HER2- advanced or metastatic breast cancer who experience disease progression AFTER ENDOCRINE therapy.

2. as monotherapy for the treatment of women with HR+/HER2- advanced or metastatic breast cancer who experience disease progression AFTER ENDOCRINE therapy AND prior CHEMOTHERAPY in the metastatic setting.

(Z) MO's have latitude to prescribe outside of these indications and there are strong arguments for doing so. My MO appears to have wide latitude to prescribe Abemaciclib and get insurance approval in other settings.

EXPANDED ACCESS:
Abemaciclib continues to be available through Lilly's attractive Expanded Access Program (EAP):
https://clinicaltrials.gov/ct2/show/NCT02792725?term=abemaciclib&rank=24
which is active and recruiting currently in several US locations (California, Florida, Minnesota, Missouri, Texas, and West Virginia), more being added. However that is for patients who have not as yet progressed on a previous CDK inhibitor like palbociclib (Ibrance), that is, for "switchers" who may want to explore the improved benefits of abemaciclib (Verzenio) over Ibrance (assuming the patient meet the other trial criteria); but not for patients who have already progressed on Ibrance.

RECHALLENGE

In several cases I have known, I counseled that although someone progressed on Ibrance, to reintroduce it after a hiatus of 3 - 6 months, and in many cases this washout appeared to resensitize the tumor cells to Ibrance, which upon re-introduction was newly effective. It is a variant of a trick I have counseled and seen working not infrequently with other agents like capecitabine (Xeloda) where after progression on it, I advised a trial on a new metronomic schedule (low-dose, continuous, daily, capecitabine) and seen again it newly effective despite previous progression, just by this shift I schedule (there is some provisional data for this, but not decisive). But these are beyond convention and reserved for highly special circumstances.

MARKERS THAT PREDICT RESPONSE TO CDK 4/6 INHIBITION
I am not convinced that there is any biomarker - protein or otherwise - that reliably identifies responsivity to CDK inhibitors, and Fabrice Andre of the Institut Gustave Roussy and colleagues, as reported in their presentation at ASCO 2017, were unable to identify any such biomarkers of response: neither Rb levels, p16 protein levels, Ki-67 cell proliferation, CDKN2A, CCND1, nor even ESR1 gene expression, all the usual suspects, and others, had any response-predictive value whatsoever. To date the only established biomarker for response to CDK4/6 inhibitors, remain hormone receptor positivity (HR+). Of course not everyone responds, but response rates remain historical high - and higher than any other treatment to date - and as long as one is HR+, one has the potential to benefit from a CDK inhibitor.

Constantine Kaniklidis
Director, Medical Research, No Surrender Breast Cancer Foundation (NSBCF)
Oncology Reviewer, Current Oncology [journal]
Society for Integrative Oncology (SIO)
Member, European Association for Cancer Research (EACR)

Ibrance/Letrozol Feb '16 -Sep '17. Adoptive Cell Therapy Oct 2017. Jan 2018 SBRT to sternum met and liver mets. Jan 2018 start Faslodex. Dx 12/28/2015, IDC, Left, 4cm, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 1/17/2016 Femara (letrozole) Targeted Therapy 2/2/2016 Ibrance (palbociclib)
Log in to post a reply

Page 59 of 64 (1,906 results)

Posts 1741 - 1770 (1,906 total)

Log in to post a reply

Jan 19, 2021 05:10PM Sadiesservant wrote:

Yup. It's been an issue for me since day one on Verzenio. I don't have it 100% of the time but need to be careful with what I eat and drink. Anything acidic will lead to problems. Typically, with chemo, I was able to manage it with a baking soda rinse but it was not at all effective with the mouth issues with Verzenio. My MO prescribed a version of their magic mouthwash which helped but was only good for a short period of time - with an ongoing issue it was too difficult to manage the logistics. He then prescribed a version which includes a steroid. That's been very helpful and lasts for months. I use it sparingly because of the steroid but when I start having trouble one or two treatments usually gets things under control.

Dx 4/2001, IDC, Right, 1cm, Stage IIA, Grade 3, 1/10 nodes, ER+ Surgery 5/10/2001 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Chemotherapy 6/7/2001 CEF Radiation Therapy 12/17/2001 Whole-breast: Breast Hormonal Therapy 12/20/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/2/2007 Femara (letrozole) Hormonal Therapy 10/21/2007 Arimidex (anastrozole) Dx 1/3/2017, IDC, Right, Stage IV, metastasized to bone/lungs, ER+/PR+, HER2- Chemotherapy 1/27/2017 Taxol (paclitaxel) Hormonal Therapy 3/28/2017 Arimidex (anastrozole) Targeted Therapy 4/19/2017 Ibrance (palbociclib) Dx 10/12/2017, IDC, Right, Stage IV, metastasized to other Chemotherapy 10/20/2017 Xeloda (capecitabine) Radiation Therapy 11/15/2017 External: Bone Hormonal Therapy 1/18/2018 Faslodex (fulvestrant) Radiation Therapy 8/2/2018 External: Bone Radiation Therapy 11/5/2018 External: Bone Targeted Therapy 10/9/2019 Verzenio Radiation Therapy 11/3/2020 External: Bone Dx 1/22/2021, IDC, Right, 1cm, Stage IV, metastasized to liver, Grade 2, ER+/PR+, HER2- Chemotherapy 2/4/2021 Xeloda (capecitabine)
Log in to post a reply

Jan 20, 2021 02:40AM Maaaki wrote:

Thanks Sadie, I also had mouth sores on kisqali but for that propolis tincture seemed to help, also it did not last long...with Verzenios is different, prescribed mouth wash works only a little, I will ask for steroid one

Dx 2013, DCIS/IDC, Right, 1cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2- Dx 5/2017, Stage IV, metastasized to bone/liver, Grade 1, ER+/PR-, HER2- Surgery Mastectomy: Right; Reconstruction (right): Silicone implant Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone), Zoladex (goserelin) Chemotherapy Surgery Hormonal Therapy Aromasin (exemestane) Hormonal Therapy Faslodex (fulvestrant) Radiation Therapy External: Bone Targeted Therapy Kisqali Surgery
Log in to post a reply

Jan 20, 2021 01:38PM woodlands wrote:

I have a friend who went through chemotherapy. I was first misdiagnosed as having regular breast cancer, and had one round of chemotherapy before the error was discovered. My friend suggested I do a "swish" every morning of coconut oil to stop the mouth sores. Here are her directions, "Do it first thing before you eat or drink and then brush your teeth. If you can't do 20 minutes, just do what you can especially in the beginning. Don't spit it in the sink. I have little plastic cups or spit it in garbage. It will clog your drain."

I took a teaspoon of coconut oil and put it in my mouth. It "melted" and then became liquid. I swished it around. I got rid of mouth sores in a few days. I don't have to take it with Verzenio, but if I ever develop a mouth sore, I swish and the sore goes away within a week or earlier.

Dx 1/12/2020, LCIS/DCIS, Left, 3cm, Stage IV, metastasized to bone, Grade 3, ER+/PR-, HER2- (FISH) Chemotherapy 2/11/2020 Hormonal Therapy 2/27/2020 Femara (letrozole) Targeted Therapy 9/8/2020 Verzenio Targeted Therapy Ibrance (palbociclib)
Log in to post a reply

Jan 20, 2021 03:13PM Hopfull2 wrote:

hi. I just took my first verzenio pill this morning. I’m crossing my fingers things go ok. I had my Zometa infusion this morning as well. So hopefully that doesn’t make me feel worse. I had forgotten to pick up the Metamucil, so I ordered it for in store pick up. I also ordered imodium too just in case. Just to have both I stock. Hope u ladies have a good day.

E🌺41yes.old/ oncotype score 39 Dx 7/5/2016, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 8/8/2016 Mastectomy: Right Surgery 9/16/2016 Mastectomy Chemotherapy 11/10/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 3/23/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 6/9/2017 Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Latissimus dorsi flap, Tissue expander placement Dx 7/2020, Stage IV, metastasized to bone, ER+/PR-, HER2- Radiation Therapy 9/8/2020 External: Bone Targeted Therapy 1/20/2021 Verzenio Hormonal Therapy Zoladex (goserelin) Hormonal Therapy Femara (letrozole) Radiation Therapy External: Bone, Brain
Log in to post a reply

Jan 20, 2021 09:05PM Hopfull2 wrote:

question for you ladies,, around what times do you guys take each pill, and so you take with food ? And do you guys take the fiber ( Metamucil ) on a daily basis or only if your having a bad day with your stomach. Thank you

E🌺41yes.old/ oncotype score 39 Dx 7/5/2016, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 8/8/2016 Mastectomy: Right Surgery 9/16/2016 Mastectomy Chemotherapy 11/10/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 3/23/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 6/9/2017 Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Latissimus dorsi flap, Tissue expander placement Dx 7/2020, Stage IV, metastasized to bone, ER+/PR-, HER2- Radiation Therapy 9/8/2020 External: Bone Targeted Therapy 1/20/2021 Verzenio Hormonal Therapy Zoladex (goserelin) Hormonal Therapy Femara (letrozole) Radiation Therapy External: Bone, Brain
Log in to post a reply

Jan 21, 2021 02:12PM HopeandGratitude wrote:

I am able to eat well so I take a Verzenio pill with breakfast (plus a few vitamins/meds etc) and the second pill at dinner with the aromatase inhibitor and other vitamins/meds. I was faithfully taking metamucil 2x/day and based on its mechanism of action, would take it EITHER 2 hours after (I prefer this) OR 1 hour before taking the verzenio to prevent any interaction, i.e. decrease in verzenio exposure. You can read this about metamucil. It was precautionary. Lately I have been taking the metamucil 1x/day as I have not been having many issues, but when I remember, I do try to get that second dose in.

Dx 3/1/2002, ILC, Left, 6cm+, Stage IIIB, Grade 3, 0/14 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 3/27/2002 CEF Chemotherapy 6/5/2002 AT Surgery 8/29/2002 Mastectomy: Left; Reconstruction (left): Free TRAM flap, Nipple reconstruction, Nipple tattoo Radiation Therapy 10/15/2002 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 1/5/2003 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 1/12/2018, IDC, Left, 2cm, Stage IIIB, Grade 3, 1/1 nodes, ER+/PR+, HER2- (FISH) Surgery 2/15/2018 Lumpectomy: Left; Lymph node removal: Left Chemotherapy 4/3/2018 CMF Chemotherapy 8/6/2018 Taxol (paclitaxel) Radiation Therapy 10/10/2018 External: Breast, Lymph nodes, Chest wall Dx 3/13/2019, IDC, 1cm, Stage IV, metastasized to liver, Grade 3, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/14/2019 Femara (letrozole) Targeted Therapy 3/24/2019 Ibrance (palbociclib) Targeted Therapy 10/24/2019 Verzenio Dx 3/18/2020, IDC, 1cm, Stage IV, metastasized to bone, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/20/2020 Aromasin (exemestane) Hormonal Therapy 4/7/2020 Faslodex (fulvestrant)
Log in to post a reply

Jan 21, 2021 03:16PM Husband11 wrote:

My wife is getting nausea from the Verzenio. She is finding that it is affecting her appetite. She has to eat plain crackers, drink ginger ale and suck on ginger lozenges in the evening. Sometime (or maybe more often) she feels nauseated in the morning and can't eat for quite a while.

Concerned husband Dx 2008, Left, Stage IIIB, Grade 3, 7/14 nodes, ER+/PR+, HER2- Dx 5/2016, Stage IV, metastasized to liver, ER+/PR+, HER2- Chemotherapy Xeloda (capecitabine) Targeted Therapy Ibrance (palbociclib) Chemotherapy Hormonal Therapy Femara (letrozole)
Log in to post a reply

Jan 21, 2021 04:07PM SeeQ wrote:

Husband11 - I had zero appetite, and actually food aversion, in the first 2-3 months and had to force myself to eat, but that resolved itself over time. I have never been a morning eater, so that's still a challenge. I try to eat and take my pills by 10, and then again between 6-7. If I take my morning pills later, I push back my nighttime pills a bit. This last week, or so, I've had less GI problems. I'm not sure why, but I'm not complaining either! Lol

Note: I'm now a lot pickier about what I'll eat now, and I allow myself the treats I used to restrict. :)

De Novo Stage IV; numerous mets in liver; single small breast tumor identified 4 weeks later Dx 6/2/2020, IDC, 6cm+, Stage IV, metastasized to liver, ER+/PR+, HER2- (IHC) Hormonal Therapy 7/3/2020 Arimidex (anastrozole) Targeted Therapy 7/10/2020 Verzenio
Log in to post a reply

Jan 21, 2021 07:00PM Sadiesservant wrote:

Hi Husband,

This has a familiar ring to it. My first two weeks on Verzenio were awful. I had so much nausea that I struggled to even get fluids into me. I couldn't cut it so reached out to my MO who immediately had me stop for two weeks and then go onto a lower dose. (I had been on 200 mg twice a day to start.) I dropped to 150 mg twice a day which was an improvement but not by much so then went to 200 mg once a day (which I took with my dinner). That made a huge difference.

I would strongly suggest a dose reduction. The problem with Verzenio is that you take it daily so there is no relief if the side effects are beating you up. At least with most chemotherapies there is a cycle of days on and days off when you can recover. Verzenio is a constant. I've been on a reduced dose for almost 15 months now and my MO is very much on board with playing with the dosage to ensure QOL doesn't suffer.

I hope she gets some relief soon.

Dx 4/2001, IDC, Right, 1cm, Stage IIA, Grade 3, 1/10 nodes, ER+ Surgery 5/10/2001 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Chemotherapy 6/7/2001 CEF Radiation Therapy 12/17/2001 Whole-breast: Breast Hormonal Therapy 12/20/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/2/2007 Femara (letrozole) Hormonal Therapy 10/21/2007 Arimidex (anastrozole) Dx 1/3/2017, IDC, Right, Stage IV, metastasized to bone/lungs, ER+/PR+, HER2- Chemotherapy 1/27/2017 Taxol (paclitaxel) Hormonal Therapy 3/28/2017 Arimidex (anastrozole) Targeted Therapy 4/19/2017 Ibrance (palbociclib) Dx 10/12/2017, IDC, Right, Stage IV, metastasized to other Chemotherapy 10/20/2017 Xeloda (capecitabine) Radiation Therapy 11/15/2017 External: Bone Hormonal Therapy 1/18/2018 Faslodex (fulvestrant) Radiation Therapy 8/2/2018 External: Bone Radiation Therapy 11/5/2018 External: Bone Targeted Therapy 10/9/2019 Verzenio Radiation Therapy 11/3/2020 External: Bone Dx 1/22/2021, IDC, Right, 1cm, Stage IV, metastasized to liver, Grade 2, ER+/PR+, HER2- Chemotherapy 2/4/2021 Xeloda (capecitabine)
Log in to post a reply

Jan 22, 2021 06:04PM HopeandGratitude wrote:

Bliss - Praying scans went ok and results even better.

Dx 3/1/2002, ILC, Left, 6cm+, Stage IIIB, Grade 3, 0/14 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 3/27/2002 CEF Chemotherapy 6/5/2002 AT Surgery 8/29/2002 Mastectomy: Left; Reconstruction (left): Free TRAM flap, Nipple reconstruction, Nipple tattoo Radiation Therapy 10/15/2002 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 1/5/2003 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 1/12/2018, IDC, Left, 2cm, Stage IIIB, Grade 3, 1/1 nodes, ER+/PR+, HER2- (FISH) Surgery 2/15/2018 Lumpectomy: Left; Lymph node removal: Left Chemotherapy 4/3/2018 CMF Chemotherapy 8/6/2018 Taxol (paclitaxel) Radiation Therapy 10/10/2018 External: Breast, Lymph nodes, Chest wall Dx 3/13/2019, IDC, 1cm, Stage IV, metastasized to liver, Grade 3, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/14/2019 Femara (letrozole) Targeted Therapy 3/24/2019 Ibrance (palbociclib) Targeted Therapy 10/24/2019 Verzenio Dx 3/18/2020, IDC, 1cm, Stage IV, metastasized to bone, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/20/2020 Aromasin (exemestane) Hormonal Therapy 4/7/2020 Faslodex (fulvestrant)
Log in to post a reply

Jan 23, 2021 01:19AM lehrski wrote:

Husband - I had a lot of nausea for the first 6 weeks and lost 12 pounds. I finally had the oncologist prescribe an anti-nausea. 6 months in, I now have no nausea at all

Dx 7/24/2020, IDC, Left, Stage IV, metastasized to bone/lungs, ER+/PR-, HER2- Targeted Therapy 8/1/2020 Verzenio Hormonal Therapy Arimidex (anastrozole)
Log in to post a reply

Jan 23, 2021 03:33AM Bliss58 wrote:

HopeandGratitude, turns out my insurance denied the PET scan at the 11th hour, so didn't have it as scheduled. They wanted me to do CT instead, but PA argued my case and won, so now I'm rescheduled for 2/1. Oh well, that gives me more time on Verzenio to see if it's making a difference. Thanks for your prayers and thinking of me.

Dx at 56 06/2015, IDC left, 4cm, de novo mets to bone; dx 04/2020 progression to liver. Dx 6/1/2015, IDC, Left, 4cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (FISH) Dx 6/30/2015, Stage IV, metastasized to bone Radiation Therapy 12/16/2015 External: Bone Surgery 2/17/2016 Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy 5/9/2016 External: Lymph nodes, Chest wall Hormonal Therapy 2/1/2018 Aromasin (exemestane) Dx 4/2020, IDC, Stage IV, metastasized to liver, Grade 3, ER+/PR+, HER2+ (IHC)
Log in to post a reply

Jan 23, 2021 08:16AM HopeandGratitude wrote:

Sorry Bliss, but yes, maybe it will all work out for best, but I know the anxiety! I used to have routine PETs until I went onto Medicare and then they were denied, so back to CT with contrast. They will allow in certain cases but for me not routine

Dx 3/1/2002, ILC, Left, 6cm+, Stage IIIB, Grade 3, 0/14 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 3/27/2002 CEF Chemotherapy 6/5/2002 AT Surgery 8/29/2002 Mastectomy: Left; Reconstruction (left): Free TRAM flap, Nipple reconstruction, Nipple tattoo Radiation Therapy 10/15/2002 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 1/5/2003 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 1/12/2018, IDC, Left, 2cm, Stage IIIB, Grade 3, 1/1 nodes, ER+/PR+, HER2- (FISH) Surgery 2/15/2018 Lumpectomy: Left; Lymph node removal: Left Chemotherapy 4/3/2018 CMF Chemotherapy 8/6/2018 Taxol (paclitaxel) Radiation Therapy 10/10/2018 External: Breast, Lymph nodes, Chest wall Dx 3/13/2019, IDC, 1cm, Stage IV, metastasized to liver, Grade 3, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/14/2019 Femara (letrozole) Targeted Therapy 3/24/2019 Ibrance (palbociclib) Targeted Therapy 10/24/2019 Verzenio Dx 3/18/2020, IDC, 1cm, Stage IV, metastasized to bone, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/20/2020 Aromasin (exemestane) Hormonal Therapy 4/7/2020 Faslodex (fulvestrant)
Log in to post a reply

Jan 24, 2021 09:24PM Hopfull2 wrote:

Hi,,,

I’m on Day 5 of Verzenio and so far no nausea and only one bout of an upset stomach which was yesterday,,, hopefully it stays this way. Not sure how long one has to be on it for the bad side effects to kick in.

Husband,,, I hope your wife finds sobe relief. I know nausea can take a toll. I had it very bad during radiation,,, I lost so much weight because of te nausea.

Bliss,,, good luck on your scans. You will be in my prayers. I know the anxiety we tend to get during scans. Hope everyone had a nice weekend.

E🌺41yes.old/ oncotype score 39 Dx 7/5/2016, DCIS/IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 8/8/2016 Mastectomy: Right Surgery 9/16/2016 Mastectomy Chemotherapy 11/10/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 3/23/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 6/9/2017 Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Latissimus dorsi flap, Tissue expander placement Dx 7/2020, Stage IV, metastasized to bone, ER+/PR-, HER2- Radiation Therapy 9/8/2020 External: Bone Targeted Therapy 1/20/2021 Verzenio Hormonal Therapy Zoladex (goserelin) Hormonal Therapy Femara (letrozole) Radiation Therapy External: Bone, Brain
Log in to post a reply

Jan 25, 2021 11:17AM nnc wrote:

Hi - would like to know if people here on Verzenio have received the COVID vaccine. In Canada the roll out of vaccines are slow, and I had heard that people who are immunocompromised such as cancer patients receiving chemotherapy might be low on the wait line, as they vaccine research team have not tested on this population during the vaccine clinical trials.

Dx 1985, DCIS, Left, Stage 0 Dx 1998, Right, Grade 2, ER+ Dx 8/2012, Stage IV, metastasized to bone/other, PR-, HER2- Hormonal Therapy 8/25/2012 Femara (letrozole) Hormonal Therapy 7/1/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 7/20/2015 Faslodex (fulvestrant) Targeted Therapy 7/20/2015 Hormonal Therapy 1/1/2017 Aromasin (exemestane) Radiation Therapy 2/1/2017 External: Lymph nodes Targeted Therapy 3/1/2017 Afinitor (everolimus) Radiation Therapy 10/18/2017 External: Bone Chemotherapy 9/1/2018 Taxol (paclitaxel) Targeted Therapy Verzenio
Log in to post a reply

Jan 25, 2021 11:26AM - edited Jan 25, 2021 12:40PM by HopeandGratitude

Hi Bliss. I see you were HER2+ (ERBB2 amp), but are now considered HER2 low - I am assuming by IHC? I am HER2-low. I wondered if you saw the recent JCO article: HER2-Low breast cancer: pathological and clinical landscape. Vol 38, Issue 17, p 1951. In the article they discuss, and there are ongoing studies - some with promising results - that show that some of the HER2 directed therapies, like ADC directed to HER2 and carrying a toxin could provide benefit to the HER2-low population, offering us more options. Obviously trastuzumab or others specific for the ERBB2 amplification would not have benefit, but others that use HER2 as a target for delivery could be very beneficial. I am keeping my eyes on this and am hopeful. They are now trying to better define HER2-low. Right now it is 1+ or 2+ by IHC and ISH negative.

I am looking at new and old options as it seems I might be coming off verzenio sooner than I hoped, which scares the heck out of me. I feel like I am on the roller coaster and coming to the top of that first big hill. I am doing ok and have been stable for almost 2 years, but nothing lasts forever. My tumor markers are now trending up. I have a scan in March so will see what's happening. If PD related to liver, likely onto affinity and aromasin/faslodex, but I am starting the search for the "what's next" after that.

Dx 3/1/2002, ILC, Left, 6cm+, Stage IIIB, Grade 3, 0/14 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 3/27/2002 CEF Chemotherapy 6/5/2002 AT Surgery 8/29/2002 Mastectomy: Left; Reconstruction (left): Free TRAM flap, Nipple reconstruction, Nipple tattoo Radiation Therapy 10/15/2002 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 1/5/2003 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 1/12/2018, IDC, Left, 2cm, Stage IIIB, Grade 3, 1/1 nodes, ER+/PR+, HER2- (FISH) Surgery 2/15/2018 Lumpectomy: Left; Lymph node removal: Left Chemotherapy 4/3/2018 CMF Chemotherapy 8/6/2018 Taxol (paclitaxel) Radiation Therapy 10/10/2018 External: Breast, Lymph nodes, Chest wall Dx 3/13/2019, IDC, 1cm, Stage IV, metastasized to liver, Grade 3, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/14/2019 Femara (letrozole) Targeted Therapy 3/24/2019 Ibrance (palbociclib) Targeted Therapy 10/24/2019 Verzenio Dx 3/18/2020, IDC, 1cm, Stage IV, metastasized to bone, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/20/2020 Aromasin (exemestane) Hormonal Therapy 4/7/2020 Faslodex (fulvestrant)
Log in to post a reply

Jan 25, 2021 02:00PM Moominmamma wrote:

nnc,

I am on verzenio/faslodex and have had my first covid vaccine. Nurse said may take me a little longer to build an immune reaction because of meds that affect immune system. Never asked what meds I was on.

Dx 8/2007, DCIS, Left, Stage 0, ER+/PR+, HER2- (IHC) Surgery 9/10/2007 Lumpectomy: Left Surgery 9/17/2007 Lumpectomy: Left Dx 5/30/2012, IDC, Left, 2cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (FISH) Surgery 7/12/2012 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement Dx 9/15/2018, Left, Stage IV, metastasized to bone/other, Grade 3, 1/1 nodes, ER+/PR+, HER2- (IHC) Hormonal Therapy 10/2/2018 Femara (letrozole) Targeted Therapy 10/6/2018 Ibrance (palbociclib) Hormonal Therapy 1/1/2021 Faslodex (fulvestrant) Targeted Therapy 1/11/2021 Verzenio Targeted Therapy Herceptin (trastuzumab) Radiation Therapy 3DCRT: Breast, Lymph nodes Chemotherapy Carboplatin (Paraplatin), Taxotere (docetaxel)
Log in to post a reply

Jan 25, 2021 02:49PM Husband11 wrote:

NNC, I just heard that in Manitoba, we are the first to come up with a consent form for people who are immune compromised, breastfeeding, or other medical categories where the vaccine might not have approval. The end result is that people who consent to the risk, don't lose priority for their category (age, personal care home, healthcare worker, etc.). Hopefully Quebec follows suit.

Concerned husband Dx 2008, Left, Stage IIIB, Grade 3, 7/14 nodes, ER+/PR+, HER2- Dx 5/2016, Stage IV, metastasized to liver, ER+/PR+, HER2- Chemotherapy Xeloda (capecitabine) Targeted Therapy Ibrance (palbociclib) Chemotherapy Hormonal Therapy Femara (letrozole)
Log in to post a reply

Jan 25, 2021 03:00PM Sadiesservant wrote:

HopeandGratitude, sorry to hear that Verzenio is perhaps coming to an end for you. I have a similar suspicion. I had a CT Scan on Friday - waiting to hear results - but have been experiencing some increased pain in my lower right ribs and abdomen for the last five weeks or so. It's getting increasingly persistent which may mean that the mets in the capsule of my liver are misbehaving. It looks like we have been on Verzenio for about the same amount of time. Disappointing and worrisome I know.

nnc, I am also in Canada and have to admit that I'm a bit frustrated by the approach to vaccinations. Here in BC they are indicating that cancer patients, originally deemed high priority, will now be in the fourth tranche if they are on active chemo or an immunosuppressive treatment. This is based on the view that the mRNA vaccine has not been tested on cancer patients as you point out. Of course the technology was developed for cancer treatment. The interesting wrinkle, they are waiting for the Astra Zeneca vaccine which is showing 70% effectiveness. If I wait longer (not currently on chemo so would be in the 50-59 age group) then I will likely receive the Pfizer or Moderna vaccine which are in the 95% range for effectiveness. Interesting...

Dx 4/2001, IDC, Right, 1cm, Stage IIA, Grade 3, 1/10 nodes, ER+ Surgery 5/10/2001 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Chemotherapy 6/7/2001 CEF Radiation Therapy 12/17/2001 Whole-breast: Breast Hormonal Therapy 12/20/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/2/2007 Femara (letrozole) Hormonal Therapy 10/21/2007 Arimidex (anastrozole) Dx 1/3/2017, IDC, Right, Stage IV, metastasized to bone/lungs, ER+/PR+, HER2- Chemotherapy 1/27/2017 Taxol (paclitaxel) Hormonal Therapy 3/28/2017 Arimidex (anastrozole) Targeted Therapy 4/19/2017 Ibrance (palbociclib) Dx 10/12/2017, IDC, Right, Stage IV, metastasized to other Chemotherapy 10/20/2017 Xeloda (capecitabine) Radiation Therapy 11/15/2017 External: Bone Hormonal Therapy 1/18/2018 Faslodex (fulvestrant) Radiation Therapy 8/2/2018 External: Bone Radiation Therapy 11/5/2018 External: Bone Targeted Therapy 10/9/2019 Verzenio Radiation Therapy 11/3/2020 External: Bone Dx 1/22/2021, IDC, Right, 1cm, Stage IV, metastasized to liver, Grade 2, ER+/PR+, HER2- Chemotherapy 2/4/2021 Xeloda (capecitabine)
Log in to post a reply

Jan 25, 2021 07:34PM - edited Jan 26, 2021 12:27AM by Bliss58

HopeandGratitude, yes I am as you say 2+ by IHC, but negative by ISH. I am aware there is testing/trials for Her2-low and the info you provide is very interesting. I hadn't seen this article, so thank you and I'll be keeping an eye on this, too. I'm sorry to hear that Verzenio may no longer be working for you and hope that's not the case.

Moominmamma, nice that you got the vaccine!

Sadieservant, thinking of you, too, as you wait for scan results and hoping for the best.


Dx at 56 06/2015, IDC left, 4cm, de novo mets to bone; dx 04/2020 progression to liver. Dx 6/1/2015, IDC, Left, 4cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (FISH) Dx 6/30/2015, Stage IV, metastasized to bone Radiation Therapy 12/16/2015 External: Bone Surgery 2/17/2016 Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy 5/9/2016 External: Lymph nodes, Chest wall Hormonal Therapy 2/1/2018 Aromasin (exemestane) Dx 4/2020, IDC, Stage IV, metastasized to liver, Grade 3, ER+/PR+, HER2+ (IHC)
Log in to post a reply

Jan 25, 2021 08:54PM HopeandGratitude wrote:

Sadiesservant, good luck with your scans on Friday. Will be in your pocket as we say. I’ll be having tumor markers tested in February and scans in March, unless there’s strong reason to do them earlier. If there is progression, I’m very tempted to start skipping testing for tumor markers on my next treatment. All this testing is nothing but anxietyprovoking and in the end, it’s the scans that matter anyway. I think I’m needing some peaceful time between the scans.

Dx 3/1/2002, ILC, Left, 6cm+, Stage IIIB, Grade 3, 0/14 nodes, ER+/PR+, HER2- (FISH) Chemotherapy 3/27/2002 CEF Chemotherapy 6/5/2002 AT Surgery 8/29/2002 Mastectomy: Left; Reconstruction (left): Free TRAM flap, Nipple reconstruction, Nipple tattoo Radiation Therapy 10/15/2002 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 1/5/2003 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 1/12/2018, IDC, Left, 2cm, Stage IIIB, Grade 3, 1/1 nodes, ER+/PR+, HER2- (FISH) Surgery 2/15/2018 Lumpectomy: Left; Lymph node removal: Left Chemotherapy 4/3/2018 CMF Chemotherapy 8/6/2018 Taxol (paclitaxel) Radiation Therapy 10/10/2018 External: Breast, Lymph nodes, Chest wall Dx 3/13/2019, IDC, 1cm, Stage IV, metastasized to liver, Grade 3, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/14/2019 Femara (letrozole) Targeted Therapy 3/24/2019 Ibrance (palbociclib) Targeted Therapy 10/24/2019 Verzenio Dx 3/18/2020, IDC, 1cm, Stage IV, metastasized to bone, ER+/PR-, HER2- (FISH) Hormonal Therapy 3/20/2020 Aromasin (exemestane) Hormonal Therapy 4/7/2020 Faslodex (fulvestrant)
Log in to post a reply

Jan 26, 2021 08:35PM Bliss58 wrote:

Did I read some pages back that some of you are experiencing hair loss with Verzenio? Quite a bit of my hair seems to be coming out in my comb every day now.

Dx at 56 06/2015, IDC left, 4cm, de novo mets to bone; dx 04/2020 progression to liver. Dx 6/1/2015, IDC, Left, 4cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (FISH) Dx 6/30/2015, Stage IV, metastasized to bone Radiation Therapy 12/16/2015 External: Bone Surgery 2/17/2016 Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy 5/9/2016 External: Lymph nodes, Chest wall Hormonal Therapy 2/1/2018 Aromasin (exemestane) Dx 4/2020, IDC, Stage IV, metastasized to liver, Grade 3, ER+/PR+, HER2+ (IHC)
Log in to post a reply

Jan 26, 2021 11:30PM SeeQ wrote:

Bliss, yes. I've been losing hair, in my hairbrush and the shower. Not so much, yet, that other people notice, but I can tell.

De Novo Stage IV; numerous mets in liver; single small breast tumor identified 4 weeks later Dx 6/2/2020, IDC, 6cm+, Stage IV, metastasized to liver, ER+/PR+, HER2- (IHC) Hormonal Therapy 7/3/2020 Arimidex (anastrozole) Targeted Therapy 7/10/2020 Verzenio
Log in to post a reply

Jan 26, 2021 11:35PM Bliss58 wrote:

SeeQ, that's me, too, and I can only think it's Verzenio. How long have you been taking it? I've been on it now close to 3 weeks.

Dx at 56 06/2015, IDC left, 4cm, de novo mets to bone; dx 04/2020 progression to liver. Dx 6/1/2015, IDC, Left, 4cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (FISH) Dx 6/30/2015, Stage IV, metastasized to bone Radiation Therapy 12/16/2015 External: Bone Surgery 2/17/2016 Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy 5/9/2016 External: Lymph nodes, Chest wall Hormonal Therapy 2/1/2018 Aromasin (exemestane) Dx 4/2020, IDC, Stage IV, metastasized to liver, Grade 3, ER+/PR+, HER2+ (IHC)
Log in to post a reply

Jan 27, 2021 12:31AM Sadiesservant wrote:

Hi Bliss,

I’ve been on it for about 15 months. I noticed in September (I think) that my hair was thinning significantly at the temples and top of my head. Of course, Murphy’s Law, I then had radiation for skull mets so lost my hair on my nape/back of my head - just to even things out. Loopy

Dx 4/2001, IDC, Right, 1cm, Stage IIA, Grade 3, 1/10 nodes, ER+ Surgery 5/10/2001 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary Chemotherapy 6/7/2001 CEF Radiation Therapy 12/17/2001 Whole-breast: Breast Hormonal Therapy 12/20/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/2/2007 Femara (letrozole) Hormonal Therapy 10/21/2007 Arimidex (anastrozole) Dx 1/3/2017, IDC, Right, Stage IV, metastasized to bone/lungs, ER+/PR+, HER2- Chemotherapy 1/27/2017 Taxol (paclitaxel) Hormonal Therapy 3/28/2017 Arimidex (anastrozole) Targeted Therapy 4/19/2017 Ibrance (palbociclib) Dx 10/12/2017, IDC, Right, Stage IV, metastasized to other Chemotherapy 10/20/2017 Xeloda (capecitabine) Radiation Therapy 11/15/2017 External: Bone Hormonal Therapy 1/18/2018 Faslodex (fulvestrant) Radiation Therapy 8/2/2018 External: Bone Radiation Therapy 11/5/2018 External: Bone Targeted Therapy 10/9/2019 Verzenio Radiation Therapy 11/3/2020 External: Bone Dx 1/22/2021, IDC, Right, 1cm, Stage IV, metastasized to liver, Grade 2, ER+/PR+, HER2- Chemotherapy 2/4/2021 Xeloda (capecitabine)
Log in to post a reply

Jan 27, 2021 12:46AM SeeQ wrote:

Bliss, I started in July. At first, I thought maybe it was from starting the AI at the same time, but it hasn't stopped after 6 mos.

De Novo Stage IV; numerous mets in liver; single small breast tumor identified 4 weeks later Dx 6/2/2020, IDC, 6cm+, Stage IV, metastasized to liver, ER+/PR+, HER2- (IHC) Hormonal Therapy 7/3/2020 Arimidex (anastrozole) Targeted Therapy 7/10/2020 Verzenio
Log in to post a reply

Jan 27, 2021 12:52AM emac877 wrote:

The saga continues. The hold up is with my insurance company. They have now decided to cover Verzenio, which is great, but for whatever reason want the prescription to be for 14 days instead of 28. I don't even know... it makes no sense. So, long story short, still waiting. I started taking my morning dose only on the 14th and have only been completely out for three days now. My MO is aware and we have both made calls back and forth between the pharmacy and the insurance but ultimately it's on the insurance company at this point. I have been told possibly Friday. So fingers crossed. I am more angry/frustrated than scared at this point.

Dx 2/8/2018, IDC, Right, 2cm, Stage IIB, Grade 2, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 3/22/2018 Lumpectomy: Right; Lymph node removal: Underarm/Axillary Chemotherapy 6/7/2018 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 8/26/2018 Whole-breast: Breast, Chest wall Dx 12/4/2019, IDC, Stage IV, metastasized to bone Surgery 12/11/2019 Radiation Therapy 12/22/2019 External: Bone Targeted Therapy 1/6/2020 Verzenio Hormonal Therapy 1/7/2020 Faslodex (fulvestrant) Hormonal Therapy 11/11/2020 Aromasin (exemestane)
Log in to post a reply

Jan 27, 2021 01:12AM - edited Jan 27, 2021 01:12AM by SeeQ

emac, that just stinks. It can be so frustrating dealing with insurance when they are interfering in your care. It just doesn't seem right. I hope you can get it sorted out.

De Novo Stage IV; numerous mets in liver; single small breast tumor identified 4 weeks later Dx 6/2/2020, IDC, 6cm+, Stage IV, metastasized to liver, ER+/PR+, HER2- (IHC) Hormonal Therapy 7/3/2020 Arimidex (anastrozole) Targeted Therapy 7/10/2020 Verzenio
Log in to post a reply

Jan 27, 2021 01:42AM Maaaki wrote:

Sadie and Hope I wish you both that verzenio still works for you. I have Mri of liver next week and they will do one more slide of spine which I had irradiated two month ago...just to check on it. Reall scan to see if SBRT on my wertebra worked will be PET CT in march. Here the insurance dont pay me for the verzenio, I have to pay myself, since I already had CDK4-6 (kisqali) and had small progression on it. It is not so expensive like in US but still a lot of money. Regarding the tumor markers I ask not to tell me however if they are good my MO always tell me that they are good, she doesnt know to shut her mouth :).

As per side effect, I get rarely diahrhea, no need for immodium and I had mouth sores, from which I thought I have osteonecrosis of the jaw... pain and swelling did not go away at one place, so I went to dentist and my wisdom teeth partialy grew..it was never out...and I am 46, well muchbetter than necrosis. Crazy life of MBC. Good luck to all of you.

Dx 2013, DCIS/IDC, Right, 1cm, Stage 0, Grade 3, 0/3 nodes, ER+/PR+, HER2- Dx 5/2017, Stage IV, metastasized to bone/liver, Grade 1, ER+/PR-, HER2- Surgery Mastectomy: Right; Reconstruction (right): Silicone implant Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone), Zoladex (goserelin) Chemotherapy Surgery Hormonal Therapy Aromasin (exemestane) Hormonal Therapy Faslodex (fulvestrant) Radiation Therapy External: Bone Targeted Therapy Kisqali Surgery
Log in to post a reply

Jan 27, 2021 08:15AM Bliss58 wrote:

Emac, how frustrating for insurance to drag their feet about your Rx. That is outrageous and I'm angry for you! Mine dispenses in 14-day increments, too, but so far I get it when ordered.

Maaaki, so glad you don't have jaw necrosis. Trusting you'll get good scan news next week. I'm due for a PET/CT 1 Feb that was canceled last week due to insurance issues. And so it goes...

Dx at 56 06/2015, IDC left, 4cm, de novo mets to bone; dx 04/2020 progression to liver. Dx 6/1/2015, IDC, Left, 4cm, Stage IIIA, Grade 2, ER+/PR+, HER2+ (FISH) Dx 6/30/2015, Stage IV, metastasized to bone Radiation Therapy 12/16/2015 External: Bone Surgery 2/17/2016 Lymph node removal: Sentinel; Mastectomy: Left Radiation Therapy 5/9/2016 External: Lymph nodes, Chest wall Hormonal Therapy 2/1/2018 Aromasin (exemestane) Dx 4/2020, IDC, Stage IV, metastasized to liver, Grade 3, ER+/PR+, HER2+ (IHC)

Page 59 of 64 (1,906 results)