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What are CDK 4/6 Inhibitors for Breast Cancer?
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- Опубліковано 3 лют 2023
- What are CDK 4/6 inhibitors? How are they taken? Can they be used to treat hormone receptor-positive breast cancer? In this video, Dr. Jennifer Griggs explains everything you need to know about CDK 4/6 inhibitors for breast cancer.
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Disclaimer: Yerbba UA-cam videos are for informational purposes only, do not constitute medical advice, and are not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your medical team, mental health professional, or other qualified health provider with any questions you may have regarding your medical condition.
Thank you for you for this. I'm stage 3b breast cancer and recently went on abemaciclib which gives me severe diarrhoea. I was worried that lowering the dose because of this would have put me to a disadvantage for the cancer returning. Your explanation has reassured me and now I won't have to worry about this problem. 🙏🏽regards from 🇬🇧
Thanks for the feedback. Wishing you the best.
Hi, please tell me how the treatment with abemaciclib is going? My mother also has stage 3B breast cancer and yesterday she started treatment with Letrozole and Verzenios (abemaciclib) 150mg
I'm about to start Kisqali on a three week cycle (along with daily letrozole) as my first line of treatment for de novo/oligometastatic MBC with bone mets. I'm scheduled for bi-weekly EKG's and bloodwork to start out, which will change to monthly checks later on. This is very helpful - thank you!
Thanks for taking the time to write. This combination is common and highly effective in most people. Wishing you the best, and keep coming back. We always have new content.
Thanks so much for the video and for the simple explanation for my daily medical reality. It will surely help my family and friends understand more about my treatment regime and side effects
Thank you so much for watching and your positive feedback.
Hello, I'm from India and my mom is MBC patient since 6 months and our doctor suggested ibrance( cydekin 100mg produced by Intas pharmaceuticals) and this has reduced my mom's cancer spread and it's coming down rapidly from 9cms to 3cms currently with almost no side effects.
The cost of the medicine is 4,600 rupees(56 American dollar). It's comparitively low when compared to other countries.
Thanks for this educational videos doctor Griggs, as always your ardent fan.
So good to hear that the cancer is responding to treatment. The costs of new drugs are often unfathomable. Eventually, they come down in price (when they are no longer on patent), but it's hard to wait for that to happen when they cost so much.
@@Subbaraosongs how much response you saw in pet scan and how much time interval it takes to get response
@@sakshampathak9019 After 6 months cancer has reduced from 9 to 3 cms and no new lesions are found.
@@sakshampathak9019 After 6 months the cancer has reduced from 9 to 3 cms and no new lesions are found.
Thank you bro ❤ wishing fast recovery for your mom❤️
This was very useful aand summarized thank you
Thank you for your kind words! We're so glad you found this video helpful.
Hello, thank you for this, I have a question regarding the use of CDK4&6 inhibitors. I want to ask about the metastatic potential of cancer cell, on treatment with these inhibitors. As CDK4 or 6 play a key role in cell proliferation, with the inhibitors, proliferation rate of cancer cell could reduce but it may allow cell to use its energy or metabolism to migrate. Are there possibilties of increase in cancer cell motility?
This is a good question. As far as we know, this is not happening in clinical settings. The responses to the CDK 4/6 inhibitors in terms of cancer response are impressive and durable. If there were to be an increase in migration, it does not appear to be clinically meaningful.
Thank you so much. Can you explaining What are the financial downsize of the assist program for the cost of care?
The financial aspects of assistance programs can vary widely but they generally aim to help reduce the cost of care. It’s best to contact the program directly to understand eligibility criteria, what costs they cover, and any potential financial responsibilities you might have as well as any unintended consequences.
Thank you very much for explaining this! I was doses down from 150mg to 100mg and was told the results will be the same. How is that? As I'm a bit paranoid that a lower dose won't help as much.
Great question. In people with side effects requiring a dose reduction, it is likely that the body is "seeing" a higher "effective" dose (this refers to the effect of the drug on the cancer). Dose reductions do not appear to affect the efficacy of the drug and, if people can stay on the medication longer, it's actually beneficial to be on a lower dose.
I tried to find any information about whether the MonarchE trial or any others have separated outcome data into lobular versus ductal cancer patients. This seems important as I understand that the recurrance risk for ductal is higher earlier, which is the period of the trials (less that 4 yrs), while recurrence risk in lobular seems higher at 8 yrs and later, which is beyond the current scope of the trial. So it would seem the data for impact in lobular patients is not yet available? Or can a difference be seen already? I can’t find data comparing the two (lobular vs ductal) and CDK 4/6 inhibitors
Good question. Lobular cancer is much less common and is therefore hard to break down in subgroup analyses. The tumor biology is more important than the histological subtype to be honest. That is, ER, PR, and HER2 are more predictive of response than ductal vs. lobular histology.
What if Ki-67 was lowered after chemo from 60% to 5%. Tumor size was 3 cm, one positive lymph node and grade 2. Surgery and radiation completed. Is Verzenio necessary in this case?
The benefit from the CDK 4/6 inhibitor abemaciclib (Verzenio) was seen in people with a good response to treatment as well as those with less of a response. Great question.
Dear Dr Griggs, please can you explain why these drugs are unsuitable for her2 positive cancers? Mine was er pos and her2 pos at biopsy but er / pr positive and her2 negative when the tumour was 3xamined after surgery having not been previously treated with herceptin. Despite this pathology i am being denied access to trials for er pos/ her2 negative cancers and am worried i will also be denied access to these drugs if i need them. I am currently awaiting a scan for possible bone mets. I am really worried that my unusual pathology results are putting me at a disadvantage at every turn for something i have no control over.
There are a couple of things here to address. A tumor that is HER2 negative multiple times after surgery is nearly 100% likely to be HER2-negative even if the biopsy specimen was HER2-positive. Biopsies are nearly all made of edges of the specimen, and edges can have something called "edge artifact." The edges are false positives.
As you referenced, clinical trials are being done to see if CDK 4/6 inhibitors can be used in people whose tumors are HER2-positive. We await the results of these trials. In general, clinical trials are open only when it is clear that someone meets all the criteria. It's not clear if you were not enrolled in a trial because the HER2 changed between biopsy and excision specimens. That seems unlikely, and your team may be able to work through your pathology report to explain this more clearly to you.
We hope this is helpful. If we missed the question, please write back!
It's possible that you're asking is why a CDK 4/6 inhibitor is not being given to you. At this point, CDK 4/6 inhibitors are given to people with metastatic disease or to people with high risk disease defined as having either ≥4 positive axillary lymph nodes, or 1-3 positive nodes with either tumor grade 3 or tumor size bigger than or equal to 5 centimeters. The criteria used to include a high Ki67, but this requirement was removed.
Thank you very much for the cancer treatment explanation. I was prescribed ribociclib recently. When I learned about side effects , I am not sure if I should take it. As I understand, it is not guaranteed that it will help, but all side effects will impact the quality of life. What is the risk of not taking it?
It's hard to know in a given patient whether it will help to take it, but in some people with a high level of something called Ki-67, it appears to improve survival in early stage breast cancer. In advanced (metastatic) disease, it is an extremely powerful medication. Side effects, if they arise, can prompt a change in dose. Most of the time, this will improve the side effects. These are terrific questions to ask your medical team.
@@yerbba Thank you so much for the further explanation/clarification. I did have a discussion with my oncologist and it was decided to go with Letrazol only for now.
Also, I am thinking of taking vitamin C via IV to support my immune system. It would be interesting to know your opinion on that.
İs this the abemaciclib drugs
That right, abemaciclib is one of the 3 CDK 4/6 inhibitor.
Well, I have to say that these medications are miracle workers. I took Kisqali for a year but already saw responds in 2 weeks (!). In little over 6 months my cancer dissapeared completely. Because of the brutal side effects, even on a lower dose, I decided to stop taking it. Almost 2 years cancer free now. Only on Letrozole. My oncologist also says that she has patients who had metastasis to the brain, liver, lungs and are completely cancer free now. Not everybody gets completely cured but this is something that previously was unheard of. It's very expensive unfortunately, but here in Brazil the health insurance pays for it. And they are now trying to get it for free as well to women without health insurance.
Thank you for sharing your experience. May I ask you how did you feel that Kiskqali started working after 2 weeks? Did you do the specific test that showed this? Also, is it safe just to stop this medication at any time?
@@elizabethdubinsky642 My right breast and armpit were filled with red spots and inflammation. It was in a horrible state, I waited too long to see an oncologist. After taking Kisqali the inflammation went down so quickly, it was unbelievable. Then it just kept getting better and better. We do a pet every 6 months. All the cancer went away and has stayed away (3 pets with ned, so far). It's very heavy medication. My blood count was borderline but I started getting chest pain, inflamed esophagus, stomach aches and extreme fatigue. Some people are feeling oke with the lower dose but I decided, against my oncologists advice, to stop. If it's safe nobody knows. I am taking part now in a study they are doing in Brazil, following women on Kisqali, so I guess they are curious as well. Time will tell!
@@nataschaelena6176 Thank you for explaining further. I am still in doubt if I should take this medication. My test for Oncotype showed that I will not benefit from Chemotherapy, but Kesqali is a new type of Chemotherapy. So, I am going to discuss with my Oncologist. Taking Letrozole only in a meantime. I wish you all the best!
@@elizabethdubinsky642 If needed I would take it again but I would never do chemotherapy. You could try it to see how your body responds. My oncologist told me that patients taking a dosage of only 2 have the same great results as patients taking 3 pills per day. You can take probiotics to protect your stomach. Whatever you chose to do, I wish you all the best on your healing journey. Because you can heal mbc.
Thank you so much for sharing your experience. I have the same level of enthusiasm for the CDK 4/6 inhibitors. About 5% of people with metastatic breast cancer will have this kind of response, so we never say "never."