Verzenio vs Ibrance?

[MacroMom]

First time posting, glad to find you! Does anyone have experience with the CDK 4/6 inhibitor abemiciclib (Verzenio)? I just started Faslodex for recurring liver mets after 14 months on Letrozole. May start Verzenio or Ibrance next month. Thanks!

[Hidden]

Hi MacroMom,

Welcome! (and, as we always add...sorry you have to be here! )

I don't have experience with that combo, but here's what I know-(which is not a lot, sorry! )

I'm on Faslodex + Palbociclib (= Ibrance), after about 4 years on Letrezole + Palbo. So, like you, I am getting treatments from both categories...endocrine/ hormonal side (e.g. Letrezole, Faslodex...) and the CDK 4/6 Inhibitor side (this did not roll off my tongue/fingertips...I looked it up and believe it is technically correct, though..), like Ibrance/Verzenio/another one, the name of which escapes me.

Ibrance was the first one out, having been approved about 4 years ago. Then the other two were approved more recently.

From my limited "did-not-even-pass-high school-chem" understanding, they are fundamentally the same with some minor differences, e.g. one or two of them you take every day, whereas Ibrance is 3 weeks on/one week off...

I am finding the Faslodex combo to be much easier to take than the Letrzole combo, but even that wasn't bad. You can see on this site that the side-effects vary greatly by person, but fatigue is common, aches, and low blood counts, e.g. neutrophils/WBC. Many women feel nearly the same as prior to treatment and continue to live pretty normal lives...

I did want to get a response out to you...but I hope that someone with Verzenio experience replies...

p.s. you've found a good website here; great women; lots of different perspectives; good info and support!

Be well,

Lynn

[MacroMom in reply to Hidden]

Thanks so much for your reply Lynn! Great that you have done so well for so long on Ibrance. I didn't have any issues with Letrozole but did it alone for 15 months before the liver mets started growing again. I've just had one round of Faslodex so far and aside from a little butt soreness no issues with that either. Next month I'll probably combine it with a CDK 4/6, just debating now about which one. Do I want diarrhea or low WBC? Such choices! My oncologist also told me about a new one coming out called Aplelisib that is specifically for people with a PIK3CA mutation in the tumor, which I have. Hoping that the side effects of that one are levitating, reversal of graying hair and increased patience!

[Hidden in reply to MacroMom]

Hi MacroMom...i have the PIK3 mutation, too! I'm so excited about this new drug coming out...another tool in the toolkit...and, omg, I'm with you re: the side-effects! Thanks for the chuckle! p.s. if you learn anything more about the Aplelisib (gosh, another drug name I'll never spell right!), please share...I don't know if everyone's been tested, but a fairly high percentage of women w/ BC have this mutation....I had my genomic testing done through Foundation One, and insurance covered 100%...

[MacroMom in reply to Hidden]

Here's a link to the article my oncologist gave me about Aplelisib. onclive.com/conference-cove...

And yes, what's with these names? Do they stick their hand in a pile of Scrabble letters, pull out 8 tiles and arrange them in the least pronounceable order?

[blms in reply to MacroMom]

Hahahah!! that made me belly laugh!! Thanks!!

[LGIA]

Hi Macro Mom,

I started on Verzenio and Faslodex when liver metastasis was discovered in October. My most recent PET scan shows that the tumors have shrunk remarkably and my oncologist is extremely surprised and pleased with the remarkable results. I hope this combination of drugs works just as well for you.

Good luck,

Anna

[MacroMom in reply to LGIA]

Hi Anna! That's great news, I'm happy for you! I'm hoping the Faslodex will shrink my liver mets back down, it would be great if it works on the tumor too. Did you have any side effects from Verzenio? I've heard that diarrhea at the beginning is pretty common. Weighing that vs the low white blood count with Ibrance.

[kearnan in reply to MacroMom]

I was recently switched from Ibrance (only did three cycles and I hated my week off which was hell) to Verzenio. I also get the falsodex injections. My onco first started me on 150 mgs. of Verzenio. She told me ONLY about the diarrhea so I brought several boxes of Imodium AD. Instead I had severe constipation (like some of the other women) and then it turned to severe diarrhea (It was like water). I could not control it and did not leave the house at all. I stopped it after two weeks saying this is no quality of life. She then lowered me to 100 mgs. of Verzenio (twice a day, same time no weeks off). I felt the same on the 100 mgs. , this time I had severe stomach pain, headaches, diarrhea which was non-stop (drank alot of gatorade) and after two weeks I stopped taking it before I even told my onco. When you are sitting there and knowing once yuo take this pill, I am going to get headaches, bone pain and extreme constipation and then diarrhea, I said no. When I went back I said it made no difference. She then said well lets try the least dose which is 50 mg. twice a day. OMG. what a difference. No more stomach pain, headaches and I didn't feel tired and I don't have to take naps. I still alternate between being constipated and then getting diarrhea but I have learned better how to adjust to it. It was a game changer for me. I hated the Ibrance. I never felt so sick as I did on my week off while other women felt the same. Everybody has different experiences. You may do well on the 150 mgs. (but expect the diarrhea), just take imodium after an episode. So now, I have been on the 50 mgs. twice per day and am so happy that I barely have any side effects, do not take naps anymore (although sometimes I feel a bit tired) and that I wake up every day knowing how I am going to feel. You may or may not have the same side effects as me. All my onco (and I think she just goes by the pamphlet) said the diarrhea is the main side effect for many women on it but for the first two weeks, I was severely constipated and then heard from other women that in the beginning they always experienced constipation. Now that I am the dose that works for me, I feel happier because I know how I am going to feel day by day. GOOD LUCK!

[kearnan in reply to MacroMom]

LOL..just see I replied to a posting from six months ago. LOL. Oh well, by now you are already on it.

[MacroMom in reply to kearnan]

Thanks anyway for replying! I actually decided not to go on Verzenio because of all the side effects. I opted for an oral chemo called Xeloda and, two months in, am happy with it. Cancer markers dropped a lot and only minor side effects so far. I agree that dosing can make a huge difference, and often lower doses are just as effective and more life affirming!

[kearnan in reply to MacroMom]

At higher doses 150 mg., then 100 mg. I had severe side effects. I quit taking both of the above doses of Verzenio after two weeks on each bc it did not make sense to them if my quality of life was so poor. But now at 50 mgs., twice per day, it makes all the difference in the world. For lack of a better word, I feel normal and the diarrhea and constipation come and go, but not that bad and I can kind of control it now. And I like that every day I get up, I know how I will feel. I feel minimal side effects. I hated the Ibrance bc my week off I was so so sick. I would need to take naps every day. I was only on Ibrance for three cycles. Not everybody has the same side effects. So its been a month now on 50 mgs. and I am happy. I used to get depressed when my week off on Ibrance was coming up. But now I am on an even keel. Best to you.

[Survivornow]

I was on 150 mg Verzenio for 6 weeks. Simply could not handle it - side effects were too much for my system. Now on Ibrance and on house lockdown because of flu in our area and my low numbers..

[kearnan in reply to Survivornow]

Your onco should have lowered your dosage. I could not handle the 150 mgs or the 100 mgs. but the 50 mgs. was the key. What a difference. I never have to take naps anymore and although my body switches from constipation to diarrhea, I can control it better now and other than that, no other side effects. Another woman I know has stage iv to the liver and has been on Ibrance for three years. She is also a school teacher in S. Dakota for 5th graders so is among kids every day and not an issue. I know another lady who is on Ibrance and still continues to work full-time as a nurse in a hospital. It's just common sense. You can still go out but just be careful around those who are sick just as you would if you were not on Ibrance. My friend said the kids in her class are always coughing, etc. but so far no problems and she plans on working full-time until retirement. She has not allowed her treatment to dictate how she lives.

[MacroMom]

Thanks so much for your reply. I've been wondering about the Verzenio side effects too, especially diarrhea. Seems the low WBC is very common with Ibrance too. We are faced with such difficult choices sometimes. I hope Ibrance is doing a number on the cancer though, that's the end game! By the way, I have bone broth every day because I have a lot of bone mets and am trying to keep the bones strong. I always make it with about 1/2 cup of dried Astragalus, a Chinese herb known to boost immunity. You can also get it in powders and capsules. I haven't even had a cold in the year since I've been adding it in and I'm around young grandkids a lot. Take care and stay well!

[blms]

Good for you! I am a big believer in Chinese medicine if you go to the right person--and that has to be a Chinese doctor trained in mainland China inaddition to your onco.

[PLASEM]

I am on Verzenio this is my first week and I don’t have diarrhea I have fatigue and nausea

[kearnan in reply to PLASEM]

What dosage? For me the side effects started (NOT the diarrhea) almost immediately. The Diarrhea came later, by the third week and that was hard to deal with. When first starting it Had stomach pain, then headaches which I never got in the past. I was put on Verzenio after I had to get off of Ibrance after three cycles due to low wbc and how horrible I felt on my week off. I was first put on Verzenio at 150 mgs. and I could not handle the side effects. My onco (who I think just reads the pamphlets and has no real clue) told me severe diarrhea. That didn't happy at first. I was the opposite and severely constipated. I could not handle the side effects and stopped after two weeks. Went down to 100 mgs. and then after like four weeks from the start of the higher dose, the diarrhea started. That was a bit hard to handle and I took Imodium AD but the side effects again were lousy and again I stopped myself after two weeks. Mainly stomach pain and the constant switch to diarrhea to constipation (Many others mentioned they too get constipated). Now on the lowest dosage 50 mgs. twice a day and what a difference. I feel normal, I no longer have to take naps, no more stomach pain and I can now manage the diarrhea and constipation. It gives me such a better quality of life. I have now been on 50 mgs. for a month and I feel almost normal. I love that I wake up knowing how I am going to feel which for the most part is normal with minimal side effects. On this lower dosage, the diarrhea is not that bad anymore and I can manage it. Made a big difference. When the diarrhea part hits, drink alot of water. I drank Gatorade bc it has electrolytes so I was drinking that non-stop. Very important to keep yourself hydrated.

[sweeetk]

Hello all, I'm going to post this in a few places. But I just want to post this here for people looking for input on Verzenio vs. Ibrance...

There are several things you can do about diarrhea; but no one can do anything about an extremely low white blood cell counts except take you off Ibrance (which doesn't help your cancer while you are off -- right?). So, definitely take the Verzenio over Ibrance if you have a choice. Also, going back to the doctor all the time to have your white blood cell count checked while on Ibrance is harder than just taking Verzenio every day.

I can vouch for this because I've been on both. I'm on Verzenio now.

Some people have extreme pain issues like me and have to take Oxycodeine/Tylenol (I take the least amount). That drug causes constipation. So, when I take it, no diarrhea. When I don't take the pain medicine, I do have diarrhea. But I could always take Immodium. There are other things that people can do to avoid diarrhea. While on Verzenio, figure out what is best for you -- anything that causes constipation might even out the diarrhea issue. Eating a lot of bananas cause constipation (good for Verzenio). Maybe do bananas and other things as well. Everyone's body is different of course.

While raising a 6 year old, I don't have a lot of time to spend on this site, but I love the support everyone provides each other!