Treatment Name: Abemaciclib (Verzenio®) + Fulvestrant (Faslodex®)
Abemaciclib (Verzenio®) + Fulvestrant (Faslodex®) is a Chemotherapy Regimen for Breast Cancer - metastatic
How does abemaciclib + fulvestrant work?
- Abemaciclib is designed to inhibit a specific protein that is responsible for turning off tumor suppressor genes and allowing the cancer cell to grow and divide. By inhibiting this protein, abemaciclib causes the cell to stop actively dividing (growing)
- Fulvestrant is designed to block estrogen receptors on the surface of breast cancer cells. In patients with Estrogen Receptor positive (ER+) disease, estrogen binds to these receptors and tells the breast cancer cells to grow and divide. Fulvestrant blocks this signal and helps stop the breast cancer cells from growing
Goals of therapy:
Abemaciclib + fulvestrant is taken to slow the growth of breast cancer and prevent it from spreading further. The chemotherapy drug combination of Abemaciclib + Fulvestrant is not commonly given with the goal of cure.
- Fulvestrant intramuscular (I.M.) injection on Days 1 and 15 of Cycle 1, then on Day 1 of subsequent (later) cycles
- Abemaciclib usual starting dose: 150 mg oral tablet by mouth twice daily
Abemaciclib is usually taken at home. Fulvestrant is usually given in an outpatient infusion center or a doctor’s clinic, allowing the person to go home afterwards.
Abemaciclib + fulvestrant is repeated every 28 days. This is known as one Cycle. Treatment is continued until it no longer works or until unacceptable side effects occur.
Click here for the common abemaciclib + fulvestrant starting doses.
In clinical studies, the most common side effects of abemaciclib + fulvestrant are shown here:
A note about side effect percentages
- Diarrhea (86%)
- Low white blood cells [neutropenia] (46%)
- Nausea (45%)
- Fatigue (40%)
- Stomach pain (35%)
- Low red blood cells [anemia] (29%)
- Decreased appetite (27%)
- Vomiting (26%)
- Headache (20%)
- Altered taste (18%)
- Low platelets [thrombocytopenia] (16%)
- Hair loss (16%)
- Mouth sores (15%)
- Constipation (14%)
- Liver injury (13%)
- Cough (13%)
- Itching (13%)
- Dizziness (13%)
- Joint pain (12%)
- Increase in blood creatinine levels (12%)
- Swelling in legs and arms (12%)
- Skin rash (11%)
- Sinus infection (11%)
- Shortness of breath (11%)
- Fever (11%)
- Muscle weakness (11%)
- Hot flash (10%)
- Weight loss (10%)
- Back pain (10%)
- Blood clots (2%)
- Neutropenic fever (1%)
On average, 16% of patients discontinue Verzenio® (abemaciclib) + Faslodex® (fulvestrant) treatment due to unacceptable side effects.
Importantly, not all people who experience a side effect from Verzenio® (abemaciclib) + Faslodex® (fulvestrant) will experience it in the same way. It may be mild in some or severe in others, depending upon the individual. Everybody is different. Additionally, side effects may vary over time. For some, side effects may be a reason to delay or switch treatment, reduce the dose, or avoid future treatment with a certain medication altogether.
Side effects may be treatable when they occur or preventable by taking certain medications before they happen. When medications are taken to prevent a problem, this is known as prophylaxis, or "prophy" for short.
After starting treatment with Verzenio® + Faslodex®, be sure to come back and watch all of the side effect videos shown below. Each of these videos contain valuable information about side effect management that will hopefully help you to both feel better and stay out of the hospital.
How often is monitoring needed?
Labs (blood tests) may be checked before treatment and periodically during treatment. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked before treatment and during treatment at the discretion of your doctor. Imaging may include: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue abemaciclib + fulvestrant as planned, reduce the dose, delay treatment until the side effect goes away, or switch to an alternative therapy.
- Diarrhea is a common side effect of abemaciclib and occurs most often during the first month of treatment. Be sure to drink plenty of fluids to stay hydrated. These symptoms may be managed with over-the-counter (OTC) medications such as loperamide (Imodium®)
- Only a certain amount of fluid volume can be given by intramuscular (I.M.) injection at one time. Because of this, the total dose of fulvestrant must be given as two separate injections on the same day. Each injection will be given slowly over 1 to 2 minutes, one in each buttock
- Changes in blood creatinine levels (a marker for kidney function) may happen during therapy with abemaciclib; however, significant kidney injury is not common
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for breast cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Abemaciclib (Verzenio®) + Fulvestrant (Faslodex®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Abemaciclib (Verzenio®) + Fulvestrant (Faslodex®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Abemaciclib (Verzenio®) + Fulvestrant (Faslodex®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Abemaciclib (Verzenio®) + Fulvestrant (Faslodex®)