Dr. Goetz on the MONARCH Trials for Breast Cancer

Matthew P. Goetz, MD, professor of oncology and pharmacology, Division of Medical Oncology, Department of Oncology, Mayo Clinic, discusses the MONARCH trials for patients with breast cancer.

The secondary analysis of the MONARCH 2 and 3 clinical studies evaluated abemaciclib (Verzenio), which is an oral CDK4/6 inhibitor and hormonal therapy. The studies attempted to determine if there were any clinical or pathological factors that might be associated with the benefit of these agents.

Common variables between the 2 studies included age, race, performance status, and presence or absence of liver metastases. According to Goetz, we identified a number of factors that were prognostic including the presence or absence of liver and bone metastasis, or progesterone receptor status.

For patients who had liver metastases, the prognosis in both studies was uniformly poor but with the addition of abemaciclib, led to substantial clinically relevant increases in progression-free survival and response rates. For example, in a patient with liver metastases in the MONARCH 2 study saw an increase in response rates from 9% to 40%.