Abemaciclib

Hi Mazie,

Finally, we get to hear from somebody in one of the trials with a 2nd gen PI3K/mTOR inhibitor! I am curious why they suggested you start on a trial, rather than Ibrance/Faslodex? Perhaps its because the progression occured while you were taking Tamoxifen? The PI3K inhibitor is supposed to enable the cancer cells to reset; and become hormone-sensitive again, it should be an excellent treatment. Do you know if the trial accepts patients who have progressed following Ibrance/Femara? Very interested to hear about your experience, and what side effects they are seeing in the trial. Do you know whether you get all three drugs, or might you be getting placebo? Have you had blood sugar problems or mouth sores? Many thanks for joining us!

cure-ious - I am hearing all over the place that Abemaciclib is working. I am guessing Mazie's doc thinks she'll do as well or better in this trial rather than the standard of care. She gets a performing CDK 4/6 inhibitor and hopefully the PI3K inhibitors works the magic and resets the cancer, as you have been saying.

Mazie - I am not on abemaciclib, but I am watching it closely. My understanding is that gastrointestinal issues are the norm on abemaciclib. I had heard that abemaciclib causes diarhea not cramps. It does mess with your gut.

The PI3K inhibitor side effects are somewhat undefined at this time.

It's clear that something is messing up your gastric system. Probiotics may be considered a supplement and not allowed on the trial. If they are allowed, take some. In any case, make yourself some homemade yogurt or buy high quality yogurt with live bacteria in it, drink kombucha and fermented drinks and research pre-biotics, which are really just foods that promote the growth of good bacteria. Gut health is your new mantra. Gut health is key to overall health as well as avoiding debilitating cramps. These drugs disturb the microbiome in your intestines.

We're very hopeful about adding PI3K inhbitors to hormonals. Adding a PI3K inhibitor to hormonals PLUS a CDK 4/6 inhibitor is potentially a lot of toxicity, but you have a very good shot at completely cornering the cancer and controlling it for a long time.

Best of luck. Hoping for frequent updates. Abemaciclib and PI3K inhibitors are front runners for the next break through in treatment protocols.

>Z<

Cure-ious - There is a lot of strategy to the sequencing of treatment. That's a brilliant observation. Putting that in my notes. I was actually thinking that I might want to add a PI3K inhibitor as soon as they came out, but it makes sense to hold it for either the second or third line, depending on how you want to move through the hormonals. Not planning to progress, of course, but it is interesting to consider ;-)

Mazie - I think this is the trial you are on. Very complicated structure. Should be of interest to anyone considering faslodex as a second line treatment or exemestane/everolimus as a third line treatment. They even have a herceptin line of treatment.

https://clinicaltrials.gov/ct2/show/NCT02057133?term=LY3023414+abemaciclib&rank=1