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Giovanna_BCNA's avatar
5 years ago

Two new compassionate access schemes for metastatic breast cancer patients - 17 June 2020

Hello everyone,

BCNA is pleased to advise that after many discussions with relevant pharmaceutical companies, two new compassionate access schemes are now open for patients wishing to access a CDK4/6 inhibitor for second or later line treatment of hormone receptor positive, HER2-negative metastatic breast cancer. To enquire about either of these programs, please speak with your medical oncologist. 

Ribociclib – first and second line treatment (Novartis)

The SPARK Plus access program, being offered by Novartis, allows eligible patients to access ribociclib (Kisqali) free of charge for first and second line treatment.

In this setting, ribociclib is given in combination with fulvestrant (Faslodex), which is not currently available through the PBS. Fulvestrant is not provided as part of SPARK Plus and must be accessed independently, which will incur a cost.

AstraZeneca currently has an access program for fulvestrant as a monotherapy. BCNA is not aware if the program is being extended to patients wishing to use fulvestrant with a CDK inhibitor.  Please speak with your medical oncologist.

Abemaciclib – third and later line treatment (Lilly)

Lilly has opened a special access scheme to provide abemaciclib (Verzenio) for third and later line treatment. Patients will be assessed on a case by case basis but must meet the eligibility criteria for the MONARCH1 trial. These include:

  • Prior endocrine therapy (but no prior CDK4/6 inhibitor)
  • At least two prior chemotherapy regimens, with at least one but no more than two in the metastatic setting and one must have included a taxane
  • Adequate organ function
  • Measurable disease according to RECIST v1.1
  • ECOG performance score of 0/1.

In this setting, abemaciclib can be given as a monotherapy or with fulvestrant.

PBS applications for ribociclib and fulvestrant

The July meeting of the Pharmaceutical Benefits Advisory Committee will consider applications for ribociclib for first and second line use, and fulvestrant in any line of treatment. BCNA has provided a submission to PBAC in support of both drugs. The outcomes of the applications are due by the end of August. For more information, see the agenda for the PBAC meeting.

 

2 Replies

  • Thank you Arpie. Patience is a virtue I’m sadly lacking in when it comes to my recovery but I know I’ll get there. 😁
  • All mine happened WELL before my BC surgery/rads, @Lesley777 - so I know I can't blame that.  Even now, with it raising its ugly head again (after the best part of 25 years since the first procedure) ....

    I am pretty sure mine is more age related than BC, as the current one is the opposite side of my surgery/Rads ...... and my surgeon (who has sadly since retired) told me that it may come back after 10 years, too :(  But I got over 20 from it, so can't really complain!

    I hope you are recovering well after your surgery - it can take up to 12 months or so!  Just make sure you do 'what they tell you' & DON'T rush it!  

    take care & all the best xx
  • Thanks for those tips. I’m currently recovering from my second shoulder surgery (3 tendons detached) - different arm. I think I need to lower my washing line too (as well as looking at the cupboards). I have been baffled as to how I caused this injury then a friend suggested it could be the radiation treatment I had.  Bingo! Looked it up and my friend was correct. (Google it). Wish I had known this, wouldn’t have changed much as I would still have had the treatment but perhaps instead of continuing my weight training I would have opted for more “gentle” exercise such as yoga. 
  • Thanks @veenaga and welcome to the forum!  Feel free to tell us your BC story so far in 'Newly Diagnosed' category. :)  ...

    Yep, I'd had the cortisone injections into both my shoulders over the years prior to my procedures being carried out - but cortisone only relieves the symptoms - it doesn't 'fix the actual problem/injury' that caused the bursitis. And you are also limited in the number of cortisone shots that you can have in the one area.  :(   Sometimes, only allowed the one!

    Bursitis is a fluid filled sac that develops after an injury, to protect the surrounding area (usually between the bone & a tendon.)  It can be drained (if done early in the piece) but if left too late (being regional, mine took time to get all the XRay/scans done that proved the bursitis was caused by an injury) then it can become thick like custard & then it can't be suctioned out by a needle (which happened to me.)   :(   If the inflammation doesn't go down after the cortisone shot, it is usually an indication that surgery may be required due to torn tendons, or actual impingement of the shoulder.  

    The shoulder is pretty well the most complicated set of bones, tendons & muscles/ligaments in the entire body - and if just one of them is damaged, torn or chipped, it needs to be addressed fairly quickly - often with surgery - as otherwise it will just continue to get worse.

    If you find that your shoulder is restricting your arm movement (eg you can't do your bra up behind your back, or can't reach up & wash your hair ..... or can't lift your arm higher than horizontal - that is the time you need to see a shoulder specialist - usually a surgeon. 

    take care
  • I have had problems with my right shoulder on and off over the years and found out I have bursitis. So yesterday I finally accepted a cortezon injection in the burser. Maybe that is what you had been experiencing all these years. No operation required. 
  • I hope that you both get some relief, @Cath62  and @cranky_granny  .... My surgeon told me that the shoulder is the most complex bit of 'moveable parts' of the whole body.  There are at least three bones, nearly a dozen different muscles and many ligaments and tendons meet in the shoulder. The way that they are connected allows us to move our arms in just about any direction we want.  The bones/tendons slide & glide over each other - and if one is compromised, the whole lot is compromised.  And the weird thing is that I am STRONGLY a right handed person - yet it was my left arm that was frozen first - and almost happening again now!  Weird!

    It involves the scapula as well!  With the frozen shoulder, it is like having it totally 'shrink wrapped' - in front of the mirror, when I DID lift my arm to shoulder height out from the side of my body, my scapula moved out with it & I almost had a 'wing'!  I knew then that no amount of physio/ultrasound/accupuncture would make no difference (which is what I was having for 6 months!) It only got worse. I could barely feed myself and couldn't wash my hair!

    The way I was grabbing the heavy stuff out (that was 'high & ahead of me and also on the left') reminded me of weight lifters picking up dumbbells and holding them out to the left & right at shoulder height & then going higher - it causes maximum stress to every bit of the shoulder!! 

    Watch out for that sturdy step ladder too, @cranky_granny ... they can bite you in the bum too!  ;)  I pretty well avoid ladders now.

    I also concentrate hot water on my shoulder every morning in the shower - at the end, I turn the heat up as high as I can tolerate and concentrate it on my left shoulder (less so on my right, as it is going OK.)

    Have fun with cleaning out your pantry @Cath62 - that job is on my list, too! I am sure a lot of tins are 'out of date' too!  :(  

    take care ladies xx
     
  • Oh I hear you @arpie. I had shoulder issues years ago but it is a sensitive area for sure. I like your cupboard idea. I am about to clean out my pantry so your post has been timely and has now given me a new direction to go with how I stack it after I clean it out. Cheers 
  • @arpie great suggestions there 
    I have sturdy  little step ladder only 2 steps which whenever things are above shoulder height. I have only developed the shoulder issues since they added the palbo to the AI (it enhances the effects of the Anastrozole) also increased the side effects. Physio did a good job getting better movement in the left shoulder and less pain. Now the right shoulder is ceasing up. So now I will have to work on it. The joys of it all. 
    Next will be the neck. I’m losing range of   movement there as well. I  refuse to put it all down to old age.