Eli Lilly's Verzenio (abemaciclib) has received two FDA approvals that significantly broaden its eligible patient population, particularly in early-stage breast cancer. These approvals have the potential to boost the drug's growth in the competitive CDK4/6 inhibitor market.
Expansion in Early Breast Cancer
The FDA has cleared Verzenio for use in patients with early-stage breast cancer without requiring Ki-67 testing. Previously, the drug's use was limited to patients who tested positive for the Ki-67 biomarker. This restriction has now been lifted, allowing Verzenio to be prescribed to patients at high risk of recurrence based on clinical factors such as tumor size, grade, and lymph node involvement.
The approval is based on the monarchE study, a Phase 3 trial that demonstrated a significant reduction in recurrence risk with the addition of Verzenio to adjuvant endocrine therapy. The study found that Verzenio plus endocrine therapy reduced the risk of recurrence by 35% compared to adjuvant endocrine therapy alone.
"This expanded approval will allow us to bring Verzenio to many more women and men with HR+, HER2-, high-risk early breast cancer in the curative setting – before patients experience recurrence, potentially to incurable metastatic disease," said Jacob Van Naarden, chief executive of the drugmaker's Loxo@Lilly subsidiary.
Approval for Pre- and Peri-Menopausal Women
In addition to the expanded early breast cancer approval, the FDA has also removed the post-menopausal restriction on Verzenio's use in advanced breast cancer. This makes Verzenio an option for all adults, including pre- and peri-menopausal women, who represent approximately 17% of the total patient population.
Other CDK4/6 inhibitors, such as Pfizer’s Ibrance (palbociclib) and Novartis’ Kisqali (ribociclib), have also received approvals for use in pre- and peri-menopausal women, making this a competitive segment of the market.
Competitive Landscape
Verzenio is now positioned to compete more effectively with Ibrance and Kisqali in the breast cancer treatment landscape. While Ibrance leads the CDK4/6 inhibitor category in sales, it failed in the PALLAS trial as adjuvant treatment for early breast cancer, giving Verzenio a unique advantage in this setting. Novartis is also looking to enter the adjuvant setting with Kisqali, with results from the NATALEE trial expected later this year.
Verzenio achieved nearly $2.5 billion in sales last year, representing an 84% increase. The new approvals are expected to further drive sales growth and solidify Verzenio's position as a key player in the breast cancer market.
