Physician Sentiment on VERZENIO®

Compiled and reviewed by the KOL Pulse research team, led by Brian Shields, Founder, KOL Pulse. Last updated 2026-07-13. KOL Pulse reports the physician conversation and does not endorse any product.

Trial 1 · NCT03155997

What do oncologists think of the monarchE trial (VERZENIO®)?

monarchE — Adjuvant HR+/HER2-, node-positive, high-risk early breast cancer

FDA APPROVED · adjuvant early BCFDA-approved for adjuvant treatment of HR-positive, HER2-negative, node-positive, high-risk early breast cancer (originally October 12, 2021; expanded March 3, 2023 to remove the Ki-67 testing requirement).

Physicians are broadly favorable, with real nuance on monarchE: 29% of 48 verified physician voices positive, 27% nuanced (praising the result while flagging a caveat), 42% neutral, 2% critical.

29%

27%

42%

Positive 29% Nuanced 27% Neutral 42% Critical 2%

Denominator: 48 distinct verified physician voices across 113 oncologist posts, 2020-09-20 to 2025-10-19. Sponsor: Eli Lilly and Company

Full conference coverage and trial data: KOL Pulse trial profile coming soon.

Primary sources: ClinicalTrials.gov · NCT03155997 · FDA — monarchE early-breast-cancer expansion (Mar 2023)

FDA approval (Mar 3, 2023): abemaciclib (Verzenio) with endocrine therapy for the adjuvant treatment of HR-positive, HER2-negative, node-positive, high-risk early breast cancer — expanding the original October 12, 2021 approval by removing the Ki-67 testing requirement (based on monarchE, NCT03155997).

Physician voices — verbatim

Representative positive voice

monarchE primary OS analysis results - Abemaciclib is the first CDK4/6i to a achieve a statistically significant OS improvement in high-risk nodal-positive HR+HER2- #BreastCancer patients #ESMO25 @OncoAlert #OncoAlert

Icro Meattini

@Icro_Meattini

Representative nuanced voice

5-year update from #monarchE now published on @JCO_ASCO. Impressive benefit with adjuvant abemaciclib in high-risk, node positive, HR+ breast cancer, with ~7% delta in distant relapse free survival. OS still immature, but trending in favor of abema. https://t.co/9Olq5dpaUs

Paolo Tarantino

@PTarantinoMD

Representative critical voice

Brilliant, eloquent & truthful By using weak(er ) surrogate end points we make patients suffer expensive, toxic treatments without any real beenfit... When will the real FDA stand up and ask for stronger end points

Bijoy Telivala

@BijoyTelivala

Full physician voice list (48)

Physician	Comment (verbatim)	Sentiment	Impressions
Manni Mohyuddin @ManniMD1	What a brilliant essay in @TheLancetOncol by some of the best minds in critical appraisal today. The shortcomings of the monarchE trial noted here apply to many of the oncology trials today. I highly recommend this read. https://t.co/CIP…	Positive	26,106
Paolo Tarantino @PTarantinoMD	5-year update from #monarchE now published on @JCO_ASCO. Impressive benefit with adjuvant abemaciclib in high-risk, node positive, HR+ breast cancer, with ~7% delta in distant relapse free survival. OS still immature, but trending in favor …	Nuanced	24,276
Harold J. Burstein, MD, PhD, FASCO @DrHBurstein	Important data from monarchE and NATALEE adjuvant CDK46 inhibitor @myESMO With @tess_omeara, here's our take on who needs, and who does not need, adjuvant abema/ribo, co-published in @Annals_Oncology	Neutral	23,720
Sara Tolaney @stolaney1	monarchE: ctDNA at baseline + 24 mo in a subset of pts Detection of ctDNA at baseline soon after completion of neo/adjuvant tx: 10/178 (5.6%) 3 of 10 cleared ctDNA + none recurred 7 of 10 had persistence + all recurred #SABCS23 @OncoAle…	Neutral	17,391
Elisa Agostinetto @ElisaAgostinett	Adjuvant CDK4/6i for early #breastcancer: how to choose wisely⁉️ In this work we discuss the most recent findings from #MonarchE and #NataLEE trials and put them in perspective for potential use in clinical practice @Lucarecco @E_de_Azambu…	Neutral	14,146
Stephanie Graff, MD, FACP, FASCO @DrSGraff	Considering Adjuvant CDK4/6 Inhibitors?: monarchE and NATALEE in Clinical Practice https://t.co/ZKomXSH3gx #bcsm @ASCO	Neutral	13,632
Erika Hamilton, MD @ErikaHamilton9	Dr. Turner presents #monarchE correlative data from WES and RNA 📍80% luminal A/B, ~75% oncotype high 📍Benefit of abema across intrinsic subtypes 📍Abema benefitted ⬆️ and⬇️ oncotype 📍benefit regardless of PI3, CCND1, maybe not among t…	Neutral	12,389
Yakup Ergün @dr_yakupergun	Excited to share our meta-analysis 💥According to the pooled analysis of the PENELOPE-B, PALLAS, MonarchE and NATALEE trials, there is a significant DFS benefit of CDK 4/6 inhibition, especially in stage 3 patients (HR: 0.67) https://t.co/…	Positive	11,585
Dr Amol Akhade @SuyogCancer	MonarchE 5 year update published in @JCO_ASCO . No OS at 5 years for adjuvant abemaciclib. HR of 0.903( 0.74 - 1.086 ) p value 0.284 CI crossing unity. Fewer OS events In Abemaciclib arm ( 208 vs 234 ). IDFS ( 7.6 % ) and DRFS ( 6.7 % ) be…	Nuanced	10,679
Bishal Gyawali @oncology_bg	I appreciate the authors’ response but the “strong correlation between DFS and OS” is not a valid statement. It’s true only for HER2+ subgroup which is not the patient population for MonarchE. We studied this correlation in the past: https:…	Nuanced	8,340
Hope Rugo @hoperugo	#ESMO25 beautiful discussion by @AngieDemichele covering monarchE and Natalie. Key points below.	Positive	8,191
Matteo Lambertini, MD PhD @matteolambe	Very sophisticated biomarker analysis of the #monarchE trial presented at #SABCS23: I was really looking forward particularly to these two slides...so far genomic testing should NOT be used for endocrine therapy choices in this setting @Onc…	Positive	4,707
Luca Arecco, MD @Lucarecco	Out on @Oncology_Ther our commentary on the main analogies and differences between #MonarchE and #NataLEE trials and perspective on CDK4/6i use in the adjuvant setting of #high-risk HR+ pts. @ElisaAgostinett @E_de_Azambuja @OncoAlert @UniG…	Neutral	4,583
Oncology Brothers @OncBrothers	4. MonarchE #Abemaciclib was approved for high risk HR+ breast cancer in adjuvant settings. Updates - iDFS improved by 7.6% (HR: 0.68) - dRFS improved by 6.7% (HR: 0.68) - Immature OS - Abema remains SoC in high risk adj HR+ breast cancer …	Nuanced	3,923
Antonio Giordano, MD PhD @antgiorda	#MonarchE #ESMO25 with median follow-up 6.3y Abemaciclib+ET reduced the risk of death by 15.8% vs ET alone (HR 0.84; 95% CI, 0.72–0.98; P = 0.027) in high risk early breast cancer-301 pts in the abema+ET and 360 pts in the ET arm had died. …	Neutral	2,504
M. Bolton @5_utr	MonarchE: a big swing and miss for abemaciclib! Now no justification for this expensive and toxic treatment! Complete failure! https://t.co/GaFecWGxcS	Neutral	2,466
Icro Meattini @Icro_Meattini	monarchE primary OS analysis results - Abemaciclib is the first CDK4/6i to a achieve a statistically significant OS improvement in high-risk nodal-positive HR+HER2- #BreastCancer patients #ESMO25 @OncoAlert #OncoAlert	Positive	2,371
Toni Choueiri, MD @DrChoueiri	JUST IN: 2 years of Abemaciclib (CDK4/6 inh) increases OVERALL SURVIVAL in HR+, HER2-, high-risk early breast cancer. Refreshing to see OS in adjuvant solid tumors! @EliLillyandCo @DFCI_BreastOnc @stolaney1 @PTarantinoMD	Neutral	2,258
Aditya Bardia, MD @dradityabardia	Positive results from Natalee trial evaluating ribociclib, CDK 4/6i with ET vs ET as adjuvant therapy for early HR+ breast cancer. Different from MONARCH-E/abemaciclib: 3 year ribo duration & inclusion of stage II-III disease. #bcsm ⁦@TRIOn…	Positive	1,545
Erman Akkus @Erman_Akkus	📑💊 Differences of CDK4/6 inhibitors @JNCI_Now ✅Preclinical ✔️Affinity to different CDKs ✔️Different effects on senescence and apoptosis ✔️These differences may affect efficacy, side effects and resistance ✅Clinical ➡️Metastatic ✔️Only …	Neutral	1,244
Jason A. Mouabbi MD @JAMouabbi	I totally agree! Showing OS benefit in the adjuvant setting of early stage HR+ HER2-ve is not easy at all! In fact I did not expect it! Thats why this is really impressive 👏🏼👏🏼👏🏼	Positive	1,194
Kazuki Nozawa, MD @kazuki_nozawa	素晴らしいニュースが飛び込んできました！術後アベマシクリブの有効性を示したmonarchE試験で、長期フォローアップにより全生存期間(OS)でも統計学的有意差を示したようです！トリネガではKN522試験がOS positiveとなり、ルミナールではmonarchE試験がpositive となりました。	Positive	1,038
Timothée Olivier, MD @Timothee_MD	As a reminder, we suggested that the iDFS gain itself, both in MonarchE and NATALEE, could have been driven by informative censoring. More details here: https://t.co/isPp5sUegp and in this peer-review publication @vkprasadlab : https:/…	Nuanced	1,030
Dr Sarah Sammons @drsarahsam	Wow, this is big. Excited to see the data. But many people have wanted OS in this population. #bcsm Lilly's Verzenio® (abemaciclib) increases overall survival in HR+, HER2-, high-risk early breast cancer with two years of therapy \| Eli Lil…	Nuanced	934
Prarthna Bhardwaj @prarthnavb	5/13 #TumorBoardTuesday 👨🏽‍🏫Mini Tweetorial 2👨🏽‍🏫 Recs: Abemaciclib 150 mg BID for 2 yrs Results of MonarchE: ✏️ iDFS @ 4y - 85.8% vs 79.4% ✏️ no OS benefit yet although numerically more favorable for Abemaciclib. Fewer deaths in abema ar…	Nuanced	863
Eddie Cliff @Eddie_Cliff	I am curious about your statement “cost effectiveness ratio of infinity” - although this drug seems unlikely to be cost effective, it is possible for a drug to provide benefit by averting metastasis/relapse & thus the need for further thera…	Nuanced	817
Bijoy Telivala @BijoyTelivala	Brilliant, eloquent & truthful By using weak(er ) surrogate end points we make patients suffer expensive, toxic treatments without any real beenfit... When will the real FDA stand up and ask for stronger end points	Negative	801
Mike Pishvaian @MPishvaian	#TumorBoardTuesday 🤔Hmmm - but no overall survival benefit 👉I get that it may be too early - but those survival curves are really overlapping 👉I am out of my zone (and probably out of my depth), but I will ask - how did the FDA approve this…	Nuanced	801
Guilherme Nader Marta @GuiNaderMarta	Genomic & transcriptomic profiling from #monarchE presented by Nick Turner at @SABCSSanAntonio Abemaciclib benefit seen accross intrinsic molecular subtypes, Oncotype risk scores & most common genomic alterations (except those w/ MYC ampl…	Neutral	791
Stefano Magno @stemagno74	"This is what is referred to as overpowering a trial—ie, designing a large trial that can detect small differences in outcomes that are statistically significant rather than clinically meaningful"	Neutral	722
Piet Ost @piet_ost	Significant but clinically irrelevant?	Nuanced	692
Santhosh Ambika @RenoHemonc	MonarchE fda approval summary- no OS yet ..	Nuanced	470
Heather McArthur, MD, MPH @hmcarthur	BTW, its coke all the way!! :)	Positive	467
Ibrahim Azar, MD @ibrahimazaronc	Impressive RFS but those OS curves look indistinguishable	Nuanced	374
Amar Kelkar, MD, MPH, FACP @amarkelkar	The problem is that it depends how you build the model. Many build models based on PFS which doesn’t make sense. I would say that a drug could be cost-effective without delta-OS if there’s a QOL improvement, but I don’t think abema would im…	Nuanced	336
Turab J Mohammed, MD @DrTJM_MD	Congratulations Dr. Gyawali and team, this is such a thought provoking piece!	Positive	286
Sheheryar Kabraji @SKabrajiMD	Need to see the crossover no? Was there sufficient CDK4/6i exposure at relapse?	Neutral	79
Gabriel Lazcano @gv_lazcano	Kaplan Meier for ants	Neutral	67
Josh Thomas Georgy @jtgeorgy	monarchE hits OS. In HR+/HER2−, node+ high-risk EBC, 2 yrs abemaciclib + ET improved overall survival vs ET alone; 7-yr landmark sustained iDFS/DRFS. Reinforces 2-yr abema+ET as adjuvant SoC. Awaiting full data, KM & hazard ratio. #monarchE…	Neutral	39
Komal Jhaveri, MD, FACP, FASCO @jhaveri_komal	Adjuvant abemaciclib is already approved for high risk node positive early stage ER positive breast cancer as there was an IDFS and distant recurrence free survival benefit- absolute benefit ~ 7%. Now we for the first time see an overall su…	Positive	38
Naoto T Ueno, MD, PhD @teamoncology	A significant milestone to show the OS improvement. The next step is to review the magnitude, toxicity, and cost to define the impact on long-term care. It is still 300K per treatment, and many people drop out.	Positive	36
Dr Rishabh Jain @DrRishabhOnco	👑 monarchE takes the crown: OS benefit in early breast cancer 🧪 Trial Design 📍 Phase III \| N = 5,637 \| 600+ sites \| 38 countries 👩‍⚕️ Population: HR⁺ / HER2⁻ / Node⁺ / High-risk • ≥4 nodes OR • 1–3 nodes + (≥5 cm 📏 tumor / Grade 3 🧬 / Ki…	Neutral	17
José Sandoval @JLSandoval	I'm reluctant of starting adjuvant abema based on MonarchE...was wondering if the insurance companies would refuse to reimburse it here in Switzerland saying the data were preliminary. To my surprise they accepted it without batting an eye.…	Neutral	0
Kari Wisinski @KariWisinski_MD	#SABCS Interesting that at 2 years there seemed to be a separation in PFS benefit w palbo. Need longer follow up on #MonarchE to make sure we don’t see this w Abema too. Is abema just early treatment of metastatic disease? Hope not.	Neutral	0
Nibash Budhathoki @Nibash_B	very relevant discussion especially for community oncologists and community breast surgeons!! @ACCCBuzz	Neutral	0
Antonio Wolff, MD (#HealthPolicyIsEconomicPolicy) @awolff	Here are the #monarchE data presented by Stephen Johnston, beautifully discussed by @GeorgeSledge51, and simultaneously published in #JCO @ASCO_pubs. Congratulations to all and a deep appreciation to study participants. A lot still to learn…	Positive	0
Eleonora Teplinsky, MD @drteplinsky	Will the results of PENELOPE-B (as well as PALLAS) and MonarchE raise influence your choice of CDK 4/6 inhibitor in the metastatic setting?#bcsm #SABCS20	Neutral	0
Enora Laas-Faron @enoralaas	Simply Brillant. Thank you @EMittendorfMD @stolaney1 for raising a question that everyone is asking on "Impact of RxPONDER and monarchE on the Surgical Management of the Axilla in Patients With Breast Cancer" https://t.co/NOOP8IXPHn @JCO_A…	Positive	0

Full conference coverage and trial data: KOL Pulse trial profile coming soon.

Trial 2 · NCT02246621

What do oncologists think of the MONARCH-3 trial (VERZENIO®)?

MONARCH-3 — First-line HR+/HER2- advanced/metastatic breast cancer (with an aromatase inhibitor)

FDA APPROVED · 1L metastatic BCFDA-approved February 26, 2018, in combination with an aromatase inhibitor as initial endocrine-based therapy for HR-positive, HER2-negative advanced or metastatic breast cancer.

Physicians are genuinely mixed on MONARCH-3: 14% of 7 verified physician voices positive, 43% nuanced (praising the result while flagging a caveat), 29% neutral, 14% critical.

14%

43%

29%

14%

Positive 14% Nuanced 43% Neutral 29% Critical 14%

Denominator: 7 distinct verified physician voices across 9 oncologist posts, 2020-12-09 to 2024-01-09. Sponsor: Eli Lilly and Company

Full conference coverage and trial data: KOL Pulse trial profile coming soon.

Primary sources: ClinicalTrials.gov · NCT02246621

Physician voices — verbatim

Representative positive voice

Monarch-3 is complicated, huh #SABCS23 friends? Monarch-3 was small (n=493) [Paloma2 n=666, MonaLeesa2 n=668] 13.1 month improvement OS, did not reach statistical significance ⚖️If it had been larger n, would the stats have tipped? 🎨In clinic, we practice the art of medicine

Stephanie Graff, MD, FACP, FASCO

@DrSGraff

Representative nuanced voice

MONARCH 3: abema with NSAI did not meet stat significance for final OS but still clinically significant 13 mo improvement and OS in subgroup with visceral dz. Smallest enrollment of all CDK4/6 trials #SABCS23

Katherine Ansley, MD

@KatherineAnsley

Representative critical voice

MONARCH 3: first-line nonsteroidal AI + abemaciclib or placebo OS benefit 13.1 mo, not statistically significant, seen across subgroups. Post-discontinuation therapies impact OS. Sample size and 2:1 randomization are also limiting. @mpgoetz @MayoClinic #SABCS23 #bcsm

Margaret Van Meter, MD

@MVanMeterMD

Full physician voice list (7)

Physician	Comment (verbatim)	Sentiment	Impressions
Stephanie Graff, MD, FACP, FASCO @DrSGraff	Monarch-3 is complicated, huh #SABCS23 friends? Monarch-3 was small (n=493) [Paloma2 n=666, MonaLeesa2 n=668] 13.1 month improvement OS, did not reach statistical significance ⚖️If it had been larger n, would the stats have tipped? 🎨In cli…	Positive	3,321
Margaret Van Meter, MD @MVanMeterMD	MONARCH 3: first-line nonsteroidal AI + abemaciclib or placebo OS benefit 13.1 mo, not statistically significant, seen across subgroups. Post-discontinuation therapies impact OS. Sample size and 2:1 randomization are also limiting. @mpgoe…	Negative	2,964
Katherine Ansley, MD @KatherineAnsley	MONARCH 3: abema with NSAI did not meet stat significance for final OS but still clinically significant 13 mo improvement and OS in subgroup with visceral dz. Smallest enrollment of all CDK4/6 trials #SABCS23	Nuanced	501
Andrea Maliachi @AndreaMaliachi	MONARCH-3 Final OS analysis.. longer OS but no statistical significance… Different drugs or different trials⁉️ #SABCS23	Nuanced	346
Dr Michelle Li @michelle_li	Updated analysis from MONARCH 3 (abemaciclib in combination with NSAI in HR+ HER2- ABC): 1. Longer mOS but not statistically significant (66.8 vs 53.7 mo) 2. Previously demonstrated PFS benefit of 14.3 months persists 3. Median improved …	Nuanced	323
Oncology Brothers @OncBrothers	#SABCS23 Highlights w/ @hoperugo on HR+ #breastcancer - #NATALEE - #MONARCH3 - #INAVO120 - #TB01 Full discussion: - https://t.co/jZrRZsOfeq - https://t.co/ovqFoUtlwT - Also on “Oncology Brothers” podcast #MedTwitter #OncTwitter #bcsm…	Neutral	0
Paolo Tarantino @PTarantinoMD	Conclusions by @prat_aleix 👉Unexpectedly (to me, at least), tumors w/ HER2E intrinsic subtype derived the greatest benefit by CDK4/6 inhibition in MONARCH trials ❗️supports the use of this strategy in #HER2+ disease (e.g. MonarcHER) #S…	Neutral	0

Full conference coverage and trial data: KOL Pulse trial profile coming soon.

Regulatory

VERZENIO® — FDA status

FDA APPROVEDVERZENIO® (abemaciclib) is FDA-approved for hormone-receptor-positive, HER2-negative breast cancer — including adjuvant treatment of node-positive, high-risk early breast cancer and, with endocrine therapy, advanced or metastatic disease. For the full, current list of FDA indications and prescribing information, see verzenio.com or FDA label (DailyMed). KOL Pulse indexes the physician conversation; the label is owned and maintained by the manufacturer.

Frequently Asked

VERZENIO® sentiment — FAQ

monarchE

What do oncologists think of the monarchE trial (VERZENIO®)?

Across 48 verified physician voices in KOL Pulse's index for monarchE, 29% expressed positive sentiment, 27% were nuanced (praising the result while flagging a caveat), 42% were neutral, and 2% were critical. Positive voices highlight the invasive-disease-free-survival benefit of adding two years of abemaciclib to endocrine therapy, and the practice-changing move of a CDK4/6 inhibitor into the curative-intent adjuvant setting; nuanced and critical voices flag immature overall survival, two-year toxicity and discontinuation, and which patients truly need escalation versus endocrine therapy alone.

Where can I find the monarchE trial data for VERZENIO® (abemaciclib)?

monarchE is registered as NCT03155997 and studied VERZENIO® (abemaciclib) in Adjuvant HR+/HER2-, node-positive, high-risk early breast cancer. KOL Pulse's monarchE trial profile is coming soon.

MONARCH-3

What do oncologists think of the MONARCH-3 trial (VERZENIO®)?

Across 7 verified physician voices in KOL Pulse's index for MONARCH-3, 14% expressed positive sentiment, 43% were nuanced (praising the result while flagging a caveat), 29% were neutral, and 14% were critical. Positive voices highlight the progression-free-survival benefit of adding abemaciclib to a first-line aromatase inhibitor in HR+/HER2- metastatic breast cancer; nuanced and critical voices flag overall-survival maturity, gastrointestinal toxicity, and how CDK4/6 inhibitors sequence and compare within the class.

Where can I find the MONARCH-3 trial data for VERZENIO® (abemaciclib)?

MONARCH-3 is registered as NCT02246621 and studied VERZENIO® (abemaciclib) in First-line HR+/HER2- advanced/metastatic breast cancer (with an aromatase inhibitor). KOL Pulse's MONARCH-3 trial profile is coming soon.

Regulatory

Is VERZENIO® (abemaciclib) FDA approved?

VERZENIO® is FDA-approved. KOL Pulse organizes this page by clinical trial and links out to the manufacturer's brand site and the FDA label for the full, current list of FDA indications and prescribing information — the label is owned and updated by the manufacturer, so we point to it rather than reproducing it.

Methodology

How this index is built

KOL Pulse indexes verbatim posts from verified oncology physicians and rolls sentiment up per clinical trial. Each physician is counted once per trial, at their highest-reach post. Sentiment is classified from the verbatim text (positive / nuanced / neutral / critical), where "nuanced" marks a voice that praises the result while flagging a substantive caveat (immature overall survival, toxicity, or trial-design/selection concerns). Institutional, media, finance, and non-physician accounts are excluded from the denominator. Quotes are reproduced verbatim and attributed to the physician's public post. KOL Pulse organizes this page by clinical trial — the maintainable unit — and links out to the manufacturer's brand site and the FDA label for the full indication list, which the manufacturer owns and updates. Trial efficacy figures are held for medical-expert verification before publication. This page reports the physician conversation; it is not medical advice and does not endorse any product.