Verzenio makes "bid with verified data” against Ibrance

[Interview] Sr. Brand Manager Jihee Kim (Verzenio marketing team at Lilly Korea)

Second CDK4/6 inhibitor… chases Ibrance with its differentiated data

Have a consistent effect on patients regardless of menstrual status

The breast cancer treatment ‘Verzenio’ is working hard to expand its market.

 

Although it is a latecomer in the CDK 4/6 inhibitor market, Lilly is showing confidence that it can bring different results from other previous treatments.

 

In fact, Verzenio is pioneering the base of use of CDK4/6 inhibitors from metastatic breast cancer to early breast cancer based on its powerful data.

 

The cyclin-dependent kinases (CDK) 4/6 inhibitors that control cell division and growth selectively inhibit the proliferation of cancer cells.

 

The drugs target human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer, which accounts for 60% of all breast cancers.

 

The drug that had opened the door to the CDK 4/6 inhibitor market was ‘Ibrance (Palbociclib).’ After it was introduced in August 2016, the drug became namely ‘the' breast cancer treatment.

 

In this sense, the market was formidable for the latecomer Verzenio (abemaciclib), which was approved in May 2019, because of the solid position established by Ibrance during the past three years.

 

Also, the misconception that “all CDK4/6 inhibitors are same” and the introduction of the third CDK4/6 inhibitor,‘ Kisqali (ribociclib),' had intensified competition in the market.

 

However, Lilly is showing extreme confidence in Verzenio.

 

In an interview with Dailypharm, Jihee Kim, a Sr.

 

Brand Manager for Verzenio at Lilly Korea, said, “Verzenio has shown consistent effect regardless of the patient's menopausal status, and extended overall survival (OS) in patients who were known to have a relatively poor prognosis.

 

Its molecular structure is slightly different from the other two drugs, which makes differences in efficacy, side effects, and administration period.

 

This is why Verzenio is preferred in treating patients with poor prognosis."

Results of the MONARCH-2 trial that allowed for the approval of Verzenio showed that the use of the Verzenio+fulvestrant combination demonstrated a significantly longer median overall survival (OS) of 46.7 months compared to the median OS of 37.3 months with fulvestrant monotherapy.

 

The primary endpoint, median progression-free survival (PFS) was 16.4 months vs 9.3 months.

 

Significant results were also obtained from its sub-analysis.

 

Verzenio had shown consistent prolongation effects in breast cancer patients with poor prognosis such as those with liver metastasis or high-grade tumors, progesterone receptor-negative patients, and those with metastasis in other areas than the bone.

 

These study data were also positively received by the clinical field and are making an impact.

 

Sales of Verzenio had surged after its reimbursement listing in June 2020 (based on IQVIA), raising ₩11.2 billion last year.

 

This is a 136% rise YoY.

 

Its sales are still far below Iblance’s sales of ₩65.6 billion, but is considered to be a smooth start.

 

Also, the hidden efforts of the marketing team had shone through.

 

Sr.

 

Manager Kim said, “Not many doctors were aware of the latecomer Verzenio at the time, and it was difficult to change the prescription pattern of the doctors as the doctors regarded all CDK4/6 inhibitors the same.

 

To overcome this, we have actively conducted symposiums and product briefings.

 

Among the healthcare professionals who attended our briefings, some hed given feedback that they would consider prescribing our drug to eligible patients and prescribed them.

 

I felt proud that we were able to deliver the value of Verzenio all the way to the patient." Also, another characteristic of Verzenio is that it is the only CDK 4/6 inhibitor that does not require a "treatment holiday." CDK 4/6 inhibitors are taken for 2 years at the longest, and therefore the management of its side effects in the early stages is very important.

 

Also, regular toxicity monitoring is essential in the early stages of administration is also essential.

 

Other drugs have a 1-week break period after 3 weeks of administration, therefore when these drugs are discontinued due to side effects, this period is extended, causing difficulties in toxicity management.

 

On the other hand, management of the daily-taken Verzenio is much simpler.

 

If a side effect arises, the patient may temporarily discontinue taking the drug and restart use after dose adjustments or the same dose as needed.

 

Verzenio can also expand the field covered by CDK4/6 inhibitors, as it has acquired positive data in early breast cancer.

 

Verzenio achieved its primary endpoint in an average follow-up period of 15.5 months as adjuvant therapy in patients with early HR+/HER2- breast cancer.

 

Although its indication has not been extended to breast cancer in Korea yet, expectations are high among HCPs in the field on the use of CDK4/6 inhibitor in early breast cancer.

 

Until then, it is most important for HCPs to use Verzenio in metastatic breast cancer and learn for themselves the characteristics of the drug and establish trust in the drug.