Lilly's Verzenio® (abemaciclib) increases overall survival in HR+, HER2-, high-risk early breast cancer with two years of therapy
Eli Lilly (NYSE:LLY) announced significant positive results from its Phase 3 monarchE trial for Verzenio, its treatment for HR+, HER2-, node-positive, high-risk early breast cancer. The study demonstrated that two years of Verzenio plus endocrine therapy achieved a statistically significant improvement in overall survival compared to endocrine therapy alone.
The seven-year landmark analysis revealed sustained benefits in both invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS). The safety profile remained consistent with previous reports, with all patients having completed or discontinued the two-year treatment course. These results establish Verzenio as the standard of care for this high-risk breast cancer patient population.
Eli Lilly (NYSE:LLY) ha annunciato risultati positivi e rilevanti dalla fase 3 dello studio monarchE per Verzenio, il suo trattamento per il carcinoma mammario in stadio iniziale HR+, HER2-, con linfonodi positivi e ad alto rischio. Lo studio ha dimostrato che due anni di Verzenio in associazione alla terapia endocrina hanno riportato un miglioramento statisticamente significativo della sopravvivenza globale rispetto alla sola terapia endocrina.
L’analisi a sette anni ha evidenziato benefici persistenti sia nella sopravvivenza libera da malattia invasiva (IDFS) sia nella sopravvivenza libera da recidiva a distanza (DRFS). Il profilo di sicurezza è rimasto coerente con quanto riportato in precedenza, con tutti i pazienti che hanno completato o interrotto il ciclo di trattamento biennale. Questi risultati consolidano Verzenio come standard di cura per questa popolazione di pazienti con carcinoma mammario ad alto rischio.
Eli Lilly (NYSE:LLY) anunció resultados positivos significativos del ensayo de fase 3 monarchE para Verzenio, su tratamiento para el cáncer de mama temprano HR+, HER2-, con ganglios positivos y alto riesgo. El estudio mostró que dos años de Verzenio más terapia endocrina lograron una mejora estadísticamente significativa en la supervivencia global en comparación con la terapia endocrina sola.
El análisis a siete años reveló beneficios sostenidos tanto en la supervivencia libre de enfermedad invasiva (IDFS) como en la supervivencia libre de metástasis a distancia (DRFS). El perfil de seguridad se mantuvo coherente con informes previos, con todos los pacientes habiendo completado o interrumpido el tratamiento de dos años. Estos resultados establecen a Verzenio como el estándar de atención para esta población de pacientes con cáncer de mama de alto riesgo.
Eli Lilly (NYSE:LLY)는 HR+, HER2-, 림프절 양성 고위험 초기 유방암 치료제인 Verzenio의 임상 3상 연구 monarchE에서 유의미한 긍정적 결과를 발표했습니다. 연구는 Verzenio를 2년간 내분비요법과 병용한 경우 내분비요법 단독보다 전체 생존률에서 통계적으로 유의한 개선을 보였음을 입증했습니다.
7년 시점 분석에서는 침습성 무병생존률(IDFS)과 원격재발 무병생존률(DRFS) 모두에서 지속적인 이점이 확인되었습니다. 안전성 프로필은 이전 보고와 일치했으며, 모든 환자는 2년 치료를 완료했거나 중단한 상태였습니다. 이러한 결과는 고위험 유방암 환자군에서 Verzenio를 치료 표준으로 확립합니다.
Eli Lilly (NYSE:LLY) a annoncé des résultats positifs significatifs de l'essai de phase 3 monarchE concernant Verzenio, son traitement pour le cancer du sein précoce HR+, HER2-, avec ganglions positifs et à haut risque. L'étude a démontré que deux ans de Verzenio en association à une hormonothérapie ont apporté une amélioration statistiquement significative de la survie globale par rapport à l'hormonothérapie seule.
L'analyse à sept ans a révélé des bénéfices durables tant sur la survie sans maladie invasive (IDFS) que sur la survie sans récidive à distance (DRFS). Le profil de sécurité est resté conforme aux rapports antérieurs, tous les patients ayant soit terminé, soit interrompu le traitement de deux ans. Ces résultats établissent Verzenio comme la référence de prise en charge pour cette population de patientes à haut risque.
Eli Lilly (NYSE:LLY) gab signifikant positive Ergebnisse der Phase-3-Studie monarchE für Verzenio bekannt, sein Medikament für HR+, HER2-, lymphknotenpositive, hohes Risiko aufweisende frühe Brustkrebspatientinnen. Die Studie zeigte, dass zwei Jahre Verzenio in Kombination mit endokriner Therapie gegenüber alleiniger endokriner Therapie eine statistisch signifikante Verbesserung des Gesamtüberlebens erzielten.
Die Sieben-Jahres-Auswertung zeigte anhaltende Vorteile sowohl beim invasiven krankheitsfreien Überleben (IDFS) als auch beim fernmetastasenfreien Überleben (DRFS). Das Sicherheitsprofil blieb mit früheren Berichten übereinstimmend, wobei alle Patientinnen den zweijährigen Behandlungszeitraum abgeschlossen oder vorzeitig abgebrochen hatten. Diese Ergebnisse etablieren Verzenio als Standardtherapie für diese Hochrisiko-Gruppe von Brustkrebspatientinnen.
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Insights
Lilly's Verzenio shows landmark overall survival benefit in early breast cancer, strengthening its market position and revenue potential.
The Phase 3 monarchE trial results for Verzenio represent a significant clinical breakthrough in early breast cancer treatment. Overall survival (OS) is the gold standard endpoint in oncology trials, and achieving this milestone with statistical significance is remarkable - especially considering the notoriously challenging path to demonstrating OS benefits in the adjuvant setting.
The trial specifically targeted HR+, HER2-, node-positive, high-risk early breast cancer - a patient population with substantial unmet needs despite being the most common breast cancer subtype. What's particularly impressive is that this survival benefit was achieved with just two years of therapy, rather than the extended treatment typically required for meaningful survival impacts.
The seven-year landmark analysis demonstrating sustained benefits in invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS) reinforces Verzenio's durable efficacy. This triple benefit across all major endpoints (OS, IDFS, DRFS) significantly strengthens Verzenio's clinical profile against competitors in the CDK4/6 inhibitor class, potentially cementing its position as the dominant therapy in this indication.
For Lilly, these results will likely drive substantial revenue growth as Verzenio solidifies its position as the standard of care in this large patient population. The company's emphasis on ensuring all eligible patients receive treatment signals confidence in both the drug's efficacy and its commercial potential. With this data, Lilly gains a significant competitive advantage in the lucrative breast cancer market, particularly as the first CDK4/6 inhibitor to demonstrate an OS benefit in the adjuvant setting.
Treatment with Verzenio plus endocrine therapy demonstrated a statistically significant and clinically meaningful improvement in overall survival compared to endocrine therapy alone
In the seven-year landmark analysis of monarchE, treatment with Verzenio also resulted in sustained invasive disease-free survival and distant relapse-free survival benefit
Results reinforce two years of Verzenio plus endocrine therapy as the standard of care in HR+, HER2-, node-positive, early breast cancer at a high risk of recurrence
The seven-year landmark analysis also demonstrated sustained benefit in invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS), reinforcing the consistency and durability of treatment effect across endpoints.
"Preventing disease relapse and helping patients live longer is the ultimate goal and a high bar in the adjuvant setting. Achieving a statistically significant OS benefit with just two years of Verzenio therapy reinforces its differentiated profile in high-risk HR+, HER2- early breast cancer," said Jacob Van Naarden, executive vice president and president of Lilly Oncology. "These data validate Verzenio as the standard-of-care for patients with node-positive, high-risk disease and increase the urgency to ensure all eligible patients are treated."
With all patients having completed or discontinued the two-year course of Verzenio, the overall safety profile of Verzenio was unchanged and consistent with previous reports.
Detailed results will be presented at a future medical meeting, submitted for publication in a peer-reviewed journal and discussed with regulatory bodies.
About the monarchE Study
monarchE was a global, randomized, open-label, two cohort, multicenter Phase 3 clinical trial that enrolled 5,637 adults with HR+, HER2-, node-positive EBC at high risk of recurrence. The study enrolled patients across more than 600 sites in 38 countries and is the only adjuvant study designed to investigate a CDK4/6 inhibitor specifically in a node-positive, high risk EBC population. To be enrolled in Cohort 1 (n=5,120), which is the FDA-approved population, patients had to have 4+ positive nodes or 1-3 positive nodes and at least one of the following: tumors that were ≥5 cm or Grade 3. Patients enrolled in Cohort 2 could not have met the eligibility criteria for Cohort 1. To be enrolled in Cohort 2 (n=517), patients had to have 1-3 positive nodes and Ki-67 score ≥
About Early Breast Cancer and Risk of Recurrence
It is estimated that
Factors associated with high risk of recurrence in HR+, HER2- early breast cancer include: positive nodal status, the number of positive nodes, large tumor size (≥5 cm), and high tumor grade (Grade 3). Node-positive means that cancer cells from the tumor in the breast have been found in the lymph nodes near the breast. Although breast cancer is removed through surgery, the presence of cancer cells in the lymph nodes signifies that there is a higher chance of developing recurrence and distant metastatic disease.
About Breast Cancer
Breast cancer is the second most commonly diagnosed cancer worldwide (following lung cancer), according to GLOBOCAN. The estimated 2.3 million new cases indicate that close to 1 in every 4 cancers diagnosed in 2022 is breast cancer. With approximately 666,000 deaths in 2022, breast cancer is the fourth-leading cause of cancer death worldwide.6 In the U.S., it is estimated that there will be more than 310,000 new cases of breast cancer diagnosed in 2024. Breast cancer is the second leading cause of cancer death in women in the U.S.7
About Verzenio® (abemaciclib)
Verzenio® (abemaciclib) is approved to treat people with certain HR+, HER2- breast cancers in the adjuvant and advanced or metastatic setting. Verzenio is the first CDK4/6 inhibitor approved to treat node-positive, high risk early breast cancer (EBC) patients.8 For HR+, HER2- breast cancer, The National Comprehensive Cancer Network® (NCCN®) recommends consideration of two years of abemaciclib (Verzenio) added to endocrine therapy as a Category 1 treatment option in the adjuvant setting.9 NCCN® also includes Verzenio plus endocrine therapy as a preferred treatment option for HR+, HER2- metastatic breast cancer.9
The collective results of Lilly's clinical development program continue to differentiate Verzenio as a CDK4/6 inhibitor. In high risk EBC, Verzenio has shown a persistent and deepening benefit beyond the two-year treatment period in the monarchE trial, an adjuvant study designed specifically to investigate a CDK4/6 inhibitor in a node-positive, high risk EBC population. 10 In metastatic breast cancer, Verzenio has demonstrated statistically significant OS in the Phase 3 MONARCH 2 study.11 Verzenio has shown a consistent and generally manageable safety profile across clinical trials.
Verzenio is an oral tablet taken twice daily and available in strengths of 50 mg, 100 mg, 150 mg, and 200 mg. Discovered and developed by Lilly researchers, Verzenio was first approved in 2017 and is currently authorized for use in more than 90 counties around the world. For full details on indicated uses of Verzenio in HR+, HER2- breast cancer, please see full Prescribing Information, available at www.Verzenio.com.
INDICATIONS FOR VERZENIO®
VERZENIO® is a kinase inhibitor indicated:
- in combination with endocrine therapy (tamoxifen or an aromatase inhibitor) for the adjuvant treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-positive, early breast cancer at high risk of recurrence.
- in combination with an aromatase inhibitor as initial endocrine-based therapy for the treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer.
- in combination with fulvestrant for the treatment of adult patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.
- as monotherapy for the treatment of adult patients with HR-positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy and prior chemotherapy in the metastatic setting.
IMPORTANT SAFETY INFORMATION FOR VERZENIO (abemaciclib)
Severe diarrhea associated with dehydration and infection occurred in patients treated with Verzenio. Across four clinical trials in 3691 patients, diarrhea occurred in 81 to
Instruct patients to start antidiarrheal therapy, such as loperamide, at the first sign of loose stools, increase oral fluids, and notify their healthcare provider for further instructions and appropriate follow-up. For Grade 3 or 4 diarrhea, or diarrhea that requires hospitalization, discontinue Verzenio until toxicity resolves to ≤Grade 1, and then resume Verzenio at the next lower dose.
Neutropenia, including febrile neutropenia and fatal neutropenic sepsis, occurred in patients treated with Verzenio. Across four clinical trials in 3691 patients, neutropenia occurred in 37 to
Monitor complete blood counts prior to the start of Verzenio therapy, every 2 weeks for the first 2 months, monthly for the next 2 months, and as clinically indicated. Dose interruption, dose reduction, or delay in starting treatment cycles is recommended for patients who develop Grade 3 or 4 neutropenia.
Severe, life-threatening, or fatal interstitial lung disease (ILD) or pneumonitis can occur in patients treated with Verzenio and other CDK4/6 inhibitors. In Verzenio-treated patients in EBC (monarchE),
Monitor patients for pulmonary symptoms indicative of ILD or pneumonitis. Symptoms may include hypoxia, cough, dyspnea, or interstitial infiltrates on radiologic exams. Infectious, neoplastic, and other causes for such symptoms should be excluded by means of appropriate investigations. Dose interruption or dose reduction is recommended in patients who develop persistent or recurrent Grade 2 ILD or pneumonitis. Permanently discontinue Verzenio in all patients with Grade 3 or 4 ILD or pneumonitis.
Grade ≥3 increases in alanine aminotransferase (ALT) (2 to
Monitor liver function tests (LFTs) prior to the start of Verzenio therapy, every 2 weeks for the first 2 months, monthly for the next 2 months, and as clinically indicated. Dose interruption, dose reduction, dose discontinuation, or delay in starting treatment cycles is recommended for patients who develop persistent or recurrent Grade 2, or any Grade 3 or 4 hepatic transaminase elevation.
Venous thromboembolic events (VTE) were reported in 2 to
Verzenio has not been studied in patients with early breast cancer who had a history of VTE. Monitor patients for signs and symptoms of venous thrombosis and pulmonary embolism and treat as medically appropriate. Dose interruption is recommended for EBC patients with any grade VTE and for MBC patients with a Grade 3 or 4 VTE.
Verzenio can cause fetal harm when administered to a pregnant woman, based on findings from animal studies and the mechanism of action. In animal reproduction studies, administration of abemaciclib to pregnant rats during the period of organogenesis caused teratogenicity and decreased fetal weight at maternal exposures that were similar to the human clinical exposure based on area under the curve (AUC) at the maximum recommended human dose. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with Verzenio and for 3 weeks after the last dose. Based on findings in animals, Verzenio may impair fertility in males of reproductive potential. There are no data on the presence of Verzenio in human milk or its effects on the breastfed child or on milk production. Advise lactating women not to breastfeed during Verzenio treatment and for at least 3 weeks after the last dose because of the potential for serious adverse reactions in breastfed infants.
The most common adverse reactions (all grades, ≥
The most frequently reported ≥
Lab abnormalities (all grades; Grade 3 or 4) for monarchE in ≥
The most common adverse reactions (all grades, ≥
The most frequently reported ≥
Lab abnormalities (all grades; Grade 3 or 4) for MONARCH 3 in ≥
The most common adverse reactions (all grades, ≥
The most frequently reported ≥
Lab abnormalities (all grades; Grade 3 or 4) for MONARCH 2 in ≥
The most common adverse reactions (all grades, ≥
The most frequently reported ≥
Lab abnormalities (all grades; Grade 3 or 4) for MONARCH 1 with Verzenio were increased serum creatinine (
Strong and moderate CYP3A inhibitors increased the exposure of abemaciclib plus its active metabolites to a clinically meaningful extent and may lead to increased toxicity. Avoid concomitant use of ketoconazole. Ketoconazole is predicted to increase the AUC of abemaciclib by up to 16-fold. In patients with recommended starting doses of 200 mg twice daily or 150 mg twice daily, reduce the Verzenio dose to 100 mg twice daily with concomitant use of strong CYP3A inhibitors other than ketoconazole. In patients who have had a dose reduction to 100 mg twice daily due to adverse reactions, further reduce the Verzenio dose to 50 mg twice daily with concomitant use of strong CYP3A inhibitors. If a patient taking Verzenio discontinues a strong CYP3A inhibitor, increase the Verzenio dose (after 3 to 5 half-lives of the inhibitor) to the dose that was used before starting the inhibitor. With concomitant use of moderate CYP3A inhibitors, monitor for adverse reactions and consider reducing the Verzenio dose in 50 mg decrements. Patients should avoid grapefruit products.
Avoid concomitant use of strong or moderate CYP3A inducers and consider alternative agents. Coadministration of strong or moderate CYP3A inducers decreased the plasma concentrations of abemaciclib plus its active metabolites and may lead to reduced activity.
With severe hepatic impairment (Child-Pugh C), reduce the Verzenio dosing frequency to once daily. The pharmacokinetics of Verzenio in patients with severe renal impairment (CLcr <30 mL/min), end stage renal disease, or in patients on dialysis is unknown. No dosage adjustments are necessary in patients with mild or moderate hepatic (Child-Pugh A or B) and/or renal impairment (CLcr ≥30-89 mL/min).
Please see full Prescribing Information and Patient Information for Verzenio.
AL HCP ISI 12OCT2021
About Lilly
Lilly is a medicine company turning science into healing to make life better for people around the world. We've been pioneering life-changing discoveries for nearly 150 years, and today our medicines help tens of millions of people across the globe. Harnessing the power of biotechnology, chemistry and genetic medicine, our scientists are urgently advancing new discoveries to solve some of the world's most significant health challenges: redefining diabetes care; treating obesity and curtailing its most devastating long-term effects; advancing the fight against Alzheimer's disease; providing solutions to some of the most debilitating immune system disorders; and transforming the most difficult-to-treat cancers into manageable diseases. With each step toward a healthier world, we're motivated by one thing: making life better for millions more people. That includes delivering innovative clinical trials that reflect the diversity of our world and working to ensure our medicines are accessible and affordable. To learn more, visit Lilly.com and Lilly.com/news, or follow us on Facebook, Instagram, and LinkedIn. P-LLY
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Cautionary Statement Regarding Forward-Looking Statements
This press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about Verzenio as a treatment for people with certain types of breast cancer and imlunestrant as a potential treatment for people with certain types of breast cancer and reflects Lilly's current beliefs and expectations. However, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of drug research, development, and commercialization. Among other things, there is no guarantee that planned or ongoing studies will be completed as planned, that future study results will be consistent with study results to date, that Verzenio will receive additional regulatory approvals, or that imlunestrant will prove to be a safe and effective treatment for certain types of breast cancer or receive regulatory approval. For further discussion of these and other risks and uncertainties that could cause actual results to differ from Lilly's expectations, see Lilly's Form 10-K and Form 10-Q filings with the United States Securities and Exchange Commission. Except as required by law, Lilly undertakes no duty to update forward-looking statements to reflect events after the date of this release.
Endnotes and References
- Johnston SRD, Harbeck N, Hegg R, et al; monarchE Committee Members and Investigators. Abemaciclib combined with endocrine therapy for the adjuvant treatment of HR+, HER2-, node-positive, high-risk, early breast cancer (monarchE) [published online ahead of print, September 20, 2020]. J Clin Oncol. doi:10.1200/JCO.20.02514.
- Verzenio [package insert]. Indianapolis, IN: Eli Lilly and Company.
- National Cancer Institute, SEER. Cancer Stat Facts: Female Breast Cancer. https://seer.cancer.gov/statfacts/html/breast.html. Accessed August 21, 2025.
- National Cancer Institute, SEER. Cancer Stat Facts: Female Breast Cancer Subtypes. https://seer.cancer.gov/statfacts/html/breast-subtypes.html. Accessed August 21, 2025.National Cancer Institute, SEER. Cancer Stat Facts: Female Breast Cancer Subtypes. https://seer.cancer.gov/statfacts/html/breast-subtypes.html. Accessed August 21, 2025.
- Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;365(9472):1687-1717. doi:10.1016/S0140-6736(05)66544-0.
- Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263.
- American Cancer Society. Cancer Statistics Center. http://cancerstatisticscenter.cancer.org. Accessed August 21, 2025.
- Verzenio. Prescribing information. Lilly
USA , LLC. - Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Breast Cancer V.2.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed May 9, 2024. To view the most recent and complete version of the guidelines, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
- Johnston SRD, Toi M, O'Shaughnessy J, Rastogi P, et al. Abemaciclib plus endocrine therapy for hormone receptor-positive, HER2-negative, node-positive, high-risk early breast cancer (monarchE): results from a preplanned interim analysis of a randomized, open-label, phase 3 trial. Lancet Oncol. 2023 Jan;24(1):77-90.
- Sledge GW Jr, Toi M, Neven P, et al. The effect of abemaciclib plus fulvestrant on overall survival in hormone receptor-positive, ERBB2–negative breast cancer that progressed on endocrine therapy—MONARCH 2: a randomized clinical trial. JAMA Oncol. 2020;6(1):116-124. doi:10.1001/jamaoncol. 2019.4782
Refer to: | Michelle Webb; michelle.webb@lilly.com; 463-206-4463 (Media) |
Michael Czapar; czapar_michael_c@lilly.com; 317-617-0983 (Investors) |
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