New Haven Register (New Haven, CT)
Yale doctor: Breast cancer drug will ‘save lives’
NEW HAVEN — A drug that has been used only in late-stage breast cancer has been approved for patients in earlier stages, improving their chances of survival, according to a Yale Cancer Center oncologist.
“It’s going to save lives. Less men and women will progress to that incurable stage of breast cancer,” said Dr. Maryam Lustberg, chief of breast oncology at the cancer center and Smilow Cancer Hospital.
The Food and Drug Administration Tuesday approved abemaciclib as a maintenance drug for breast cancers that are estrogen receptor positive, which account for twothirds of all breast cancers, Lustberg said. It can be given along with estrogen blockers that typically are given after surgery, chemotherapy or radiation, she said. It is marketed by Eli Lilly & Co. as Verzenio.
The drug differs from chemotherapy in that it targets a particular mechanism in the cancer cell, rather than all rapidly multiplying cells. “We call them smart pills or targeted therapies because they target a very specific part of tumor growth,” Lustberg said. Abemaciclib targets two enzymes that are “related to the growth machinery of the tumor cells ... They essentially put the brakes on it,” she said.
“This FDA approval is essentially adding a second pill to help the estrogen pill work better,” Lustberg said.
“You had patients who maybe had a higher risk of breast cancer, higher stage, positive lymph nodes,” she said. “They would do everything right. Sometimes years later it would actually present with a more advanced breast cancer or metastatic breast cancer, which is deadly. It’s no longer curable.”
Breast cancer that has metastasized, or spread to other parts of the body, is stage 4.
The approval has “huge ramifications” for cancer treatment, Lustberg said. It is the first of the “next generation of drugs” targeted for a particular type of cancer, allowing for more personalized medicine, she said. Another, ribociclib, trade name Kisqali, still is under study, she said. They are the “new kids on the block” in cancer treatment, she said.
Only patients at high risk will be eligible, meaning those with stage 2 or 3 breast cancer that has spread to the lymph nodes and which has a marker of rapid growth. That is a measure of how rapidly the cancer cells are dividing at diagnosis.
In the phase 3 trial, known as monarchE, half of patients were given abemaciclib. “The half that got the smart therapy actually had lower recurrences,” Lustberg said.