Abemaciclib
Verzenio
Verzenio is a pivotal treatment for hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic breast cancer. This targeted therapy inhibits cyclin-dependent kinases 4 and 6, crucial in cell cycle regulation, slowing cancer cell proliferation, and controlling disease progression. Verzenio is versatile and can be combined with an aromatase inhibitor or fulvestrant, depending on prior treatment responses. Available in tablet form with strengths of 50 mg, 100 mg, 150 mg & 200 mg, it accommodates various dosing strategies to optimize patient outcomes. Typically administered twice daily, it can be taken with or without food and adjusted for specific patient needs, including those with hepatic or renal impairments. While effective, Verzenio requires monitoring for side effects such as diarrhea and neutropenia and severe conditions like venous thromboembolism. Regular follow-up is essential to manage risks and ensure treatment efficacy, making Verzenio a cornerstone of advanced breast cancer management. If you’re exploring treatment options, you can conveniently buy Verzenio online from Canada.
Product Overview
Verzenio (abemaciclib) is a targeted therapy used to treat hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced or metastatic breast cancer. It is particularly effective when used in combination with an aromatase inhibitor as initial endocrine-based therapy in postmenopausal women or men or with fulvestrant in patients who have shown disease progression following endocrine therapy. Verzenio works by selectively inhibiting cyclin-dependent kinases (CDK) 4 and 6, enzymes crucial in regulating the cell cycle. By blocking these pathways, Verzenio effectively slows the proliferation of cancer cells, thereby controlling disease progression and potentially enhancing patient outcomes.
Available in tablet form, Verzenio has four strengths: 50 mg, 100 mg, 150 mg & 200 mg, allowing for flexible dosing that can be adjusted based on the patient’s response and tolerance to the treatment. The recommended dosage varies, with 200 mg twice daily for monotherapy and 150 mg twice daily when combined with other cancer therapies. Verzenio is typically taken twice daily, approximately 12 hours apart, with or without food & should be swallowed whole. Dose adjustments may be necessary in response to adverse reactions or specific patient needs, such as in those with hepatic or renal impairment.
Verzenio has a well-established safety profile with manageable side effects, including diarrhea, neutropenia, and elevated liver enzymes. However, it requires careful monitoring for more serious conditions like venous thromboembolism and interstitial lung disease. Regular follow-up care and proactive management of side effects are essential to maximize the therapeutic benefits of Verzenio while minimizing its risks. This precision medicine offers a promising treatment option for advanced breast cancer, significantly improving disease progression and quality of life for many patients. For those looking to buy Verzenio online, ensure you consult a healthcare professional for proper guidance and dosing.
What Are the Uses of Verzenio?
Treatment of HR+ (Hormone Receptor Positive), HER2- (Human Epidermal Growth Factor Receptor 2 Negative) advanced or metastatic breast cancer in combination with:
- An aromatase inhibitor as initial endocrine-based therapy in postmenopausal women or men.
- Fulvestrant in women with disease progression following endocrine therapy.
What Are the Forms & Strengths of Verzenio?
Verzenio is available in tablet form with the following strengths:
- 50 mg tablets
- 100 mg tablets
- 150 mg tablets
- 200 mg tablets
What Are the Recommended Dosage of Verzenio?
The recommended dosage of Verzenio varies depending on the specific indications and whether it’s combined with other therapies. Here are general guidelines based on different scenarios:
For HR+ (Hormone Receptor Positive), HER2- (Human Epidermal Growth Factor Receptor 2 Negative) Advanced or Metastatic Breast Cancer:
- Monotherapy (when used alone): The typical starting dose is 200 mg orally twice daily.
- Combination Therapy:
- With Fulvestrant: The recommended dose of Verzenio is 150 mg twice daily for patients who have progressed following endocrine therapy. This is combined with Fulvestrant, administered according to its prescribing information.
- With an Aromatase Inhibitor: For those who are hormone receptor-positive and HER2-negative and have not received prior endocrine therapy, Verzenio is used at 150 mg twice daily with an aromatase inhibitor.
Dose Adjustments for Adverse Reactions:
- Management of Adverse Reactions: Dose adjustments are recommended based on individual tolerance and the severity of adverse reactions. The first dose reduction should decrease the dose to 150 mg twice daily. A second dose reduction may bring it down to 100 mg twice daily, and a third reduction (if necessary) to 50 mg twice daily.
- Permanent Discontinuation: This is recommended for patients unable to tolerate 50 mg twice daily or those who continue to experience clinically significant adverse reactions at this dose level.
Considerations for Specific Populations:
- Patients with Hepatic Impairment: Lower starting doses are recommended for patients with moderate & severe hepatic impairment. For instance, start with 100 mg twice daily for moderate impairment and adjust as tolerated.
- Patients with Renal Impairment: No dose adjustment of Verzenio is necessary for patients with mild to moderate renal impairment. Limited data exist for patients with severe renal impairment or end-stage renal disease.
[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor & they’ll customize your dosage accordingly.]
How to Use Verzenio?
Using Verzenio correctly is crucial for maximizing its effectiveness and minimizing potential side effects. Here’s a step-by-step guide on how to use Verzenio:
- Follow your healthcare provider’s instructions precisely regarding the dosage and timing of Verzenio. It is typically taken twice a day, about 12 hours apart.
- Verzenio can be taken with or without food. Choose a method that best fits your routine, but be consistent each day to maintain stable levels of the medication in your body.
- The tablets should be swallowed whole with water. Do not chew, crush, or split the tablets, as this could release the drug too quickly and increase side effects.
- If you miss a dose and it’s closer to the time of your next dose, skip the missed dose & resume your regular schedule. Do not take double doses of Verzenio to make up for missed ones.
- Regular follow-up appointments with your healthcare expert are essential. They’ll monitor your response to the treatment & side effects and may adjust your dose if necessary.
- Be aware of potential side effects, such as diarrhea, low white blood cell counts, liver problems, etc. Contact your healthcare provider if you experience significant side effects. They may prescribe medications to manage them or adjust your Verzenio dose.
- Keep Verzenio out of reach of children and store it in its original container at an average room temperature, away from moisture & heat.
- Always keep an open line of communication with your healthcare provider. Inform them about all your medications and any changes in your health condition.
[Note: Your doctor will decide the appropriate amount for you based on your health condition, following guidelines & studies on the drug. They’ll adjust it as needed over time.]
How Does Verzenio Work?
Verzenio functions as a targeted cancer therapy specifically designed to combat certain types of breast cancer. It works by inhibiting the activity of enzymes known as cyclin-dependent kinases (CDK) 4 and 6. These enzymes play a crucial role in regulating cell division. In many cancers, including hormone receptor-positive (HR+) breast cancer, CDK4 and CDK6 are overactive, leading to uncontrolled cell growth. By inhibiting these kinases, Verzenio effectively slows down the proliferation of cancer cells, thereby helping to control the disease. This mechanism of action targets the cancer cells more directly, which can lead to fewer side effects typically associated with conventional chemotherapy that affect all rapidly dividing cells.
Verzenio tablet is commonly used in combination with other therapies, such as hormone therapy, enhancing the overall effectiveness of the treatment by attacking the cancer on multiple fronts. This strategic approach aims to improve outcomes and manage the disease more effectively.
Important Safety Information for Using Verzenio
What Are the Side Effects of Verzenio?
Common side effects of Verzenio
Verzenio is a targeted therapy used in the treatment of certain types of breast cancer. Here are the common side effects associated with its use:
- Gastrointestinal issues:
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- Diarrhea: The most frequently reported side effect, often occurring during the first month of treatment. It can lead to dehydration and may require anti-diarrheal medications.
- Nausea and Vomiting: Patients may experience nausea and vomiting, which can be managed with antiemetic medications and dietary adjustments.
- Decreased Appetite: A reduction in appetite is common, potentially leading to weight loss. Monitoring nutritional intake is important to maintain overall health.
- Abdominal Pain: Some individuals may experience stomach discomfort or pain, which should be reported to a healthcare provider for appropriate management.
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- Blood-related effects:
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- Neutropenia: A decrease in white blood cells, increasing the risk of infections. Regular blood tests are necessary to monitor blood cell counts.
- Anemia: Lowered red blood cell counts can cause fatigue and weakness. Treatment may involve dietary changes or medications to boost red blood cell production.
- Thrombocytopenia: Reduced platelet counts can lead to increased bruising and bleeding. Patients should avoid activities that may cause injury and report any unusual bleeding.
- Fatigue and Weakness: General tiredness and lack of energy are common. Balancing rest with light activity can help manage these symptoms.
- Hair Thinning or Loss: Some patients may experience hair thinning or loss. This is usually temporary and may reverse after treatment ends.
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- Skin-related issues:
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- Rash and Dry Skin: Skin reactions such as rashes or dryness can occur. Using gentle skin care products and moisturizing regularly can alleviate discomfort.
- Headache and Dizziness: Some individuals may experience headaches or dizziness. Staying hydrated and resting can help manage these symptoms.
- Altered Taste: Changes in taste perception are possible, which may affect appetite. Experimenting with different foods and flavors can help maintain nutritional intake.
- Liver Enzyme Elevations: Increased liver enzymes may indicate liver stress. Regular blood tests are conducted to monitor liver function during treatment.
- Venous Thromboembolism: There is a risk of developing blood clots. Patients should be aware of symptoms like swelling, pain, or redness in the limbs and seek immediate medical attention if they occur.
Serious side effects of Verzenio
Verzenio can cause serious side effects. Patients should be aware of these potential medication risks & discuss them with their healthcare professional. Here are some of the severe side effects associated with Verzenio:
- Diarrhea: This is one of the most common serious side effects and can occur frequently. It can be severe & may require medical intervention to prevent dehydration.
- Neutropenia: A significant reduction in white blood cell counts, particularly neutrophils, can increase the risk of infection. Routine blood tests are required to monitor levels.
- Liver Toxicity: Verzenio can cause hepatotoxicity, which may manifest as increased liver enzymes. Liver function tests should be conducted before starting treatment & periodically after that.
- Venous Thromboembolism: The risk of blood clots in the veins is increased, which can be potentially life-threatening. Symptoms like swelling, leg redness, and shortness of breath require immediate medical attention.
- Pulmonary Embolism: Blood clots can potentially also travel to the lungs, an issue known as pulmonary embolism, which is severe and can be fatal.
- Interstitial Lung Disease/Pneumonitis: Some patients may develop lung problems, presenting as difficulty breathing, cough, and fatigue. If respiratory symptoms develop, immediate evaluation is necessary.
- Severe Infections: Due to neutropenia, patients may be more susceptible to severe bacterial, fungal, or viral infections.
[Note: Remember, this list does not cover all possible side effects of Verzenio. Always consult with your healthcare expert for medical help about side effects.]
Are There Any Warnings for Verzenio?
Verzenio can lead to significant health concerns, particularly for specific individuals. Discuss with your healthcare provider if you have concerns about the following potential risks:
- Diarrhea: This is a common side effect for patients taking Verzenio, sometimes leading to severe dehydration or infection. Diarrhea typically begins within the first few weeks of treatment and can persist for up to two weeks. At the first sign of diarrhea, contacting your healthcare team is crucial, as they may recommend an antidiarrheal medication such as loperamide (Imodium). Adjustments to your medication, such as dosage reductions or temporary discontinuation, may be necessary. Remember, staying hydrated is vital during this period.
- Low White Blood Cell Counts: Verzenio can lower your white blood cell count, increasing your risk of infections. Regular blood count checks are essential, especially biweekly at the start of treatment and less frequently after that. Monitor your temperature regularly, and notify your oncologist if you develop a fever or feel unwell. Your treatment plan may need to be adjusted accordingly.
- Lung Problems: Although rare, Verzenio can cause severe lung issues, including inflammation or interstitial lung disease. Inform your oncologist if you experience any new or worsening respiratory symptoms. Depending on your condition, your dose may need to be reduced or stopped.
- Liver Problems: Verzenio may increase certain liver enzymes, indicating potential liver issues. This typically occurs within 3 to 6 months of starting treatment. Regular liver function tests are necessary as elevated enzyme levels often don’t show symptoms. Notify your healthcare professional team immediately if you experience fatigue, loss of appetite, pain on the right side of your stomach, or easy bruising or bleeding.
- Blood Clots: Though uncommon, Verzenio has been associated with the build-up of blood clots in the veins. If you experience symptoms such as pain or swelling in your limbs, difficulty breathing, chest pain, or a rapid heartbeat, you should seek medical attention at the earliest you should seek immediate medical attention.
- Risk to Unborn Baby: Verzenio can harm an unborn baby, as indicated by animal studies. Women who are pregnant or may become pregnant should have a pregnancy test before starting treatment and use effective contraception during treatment and for three weeks after the final dose. Notify your oncologist immediately if you become pregnant while taking Verzenio.
What Are the Verzenio Precautions?
When taking Verzenio, it is essential to consider several precautions to manage potential risks and enhance the effectiveness of the treatment. Here are the critical precautions for patients using Verzenio:
- Monitor for Side Effects: Regular monitoring for side effects such as diarrhea, low white blood cell counts, liver issues, lung problems, and signs of blood clots is crucial. If you experience any symptoms associated with these conditions, immediately communicate with your healthcare provider.
- Blood Tests: Frequent blood tests are required to monitor your liver function & blood cell counts, particularly when starting treatment, as Verzenio can cause changes in liver enzymes and lower white blood cell counts.
- Avoid Pregnancy: Verzenio can harm an unborn baby, so it is vital for women who can become pregnant to use effective contraception during medical treatment and for at least three weeks after the last dose. Pregnancy testing before starting treatment is recommended for women of reproductive potential.
- Manage Diarrhea: Diarrhea is a common side effect. Patients should start treatment for diarrhea at the first sign of loose stools by using medications such as loperamide and ensuring adequate hydration.
- Interaction with Other Medications: Patients should inform their healthcare specialist about all their medications, including over-the-counter drugs and herbal supplements, as Verzenio can interact with other medicines, particularly those that affect liver enzymes.
- Avoid Grapefruit and Grapefruit Juice: Grapefruit & grapefruit juice can increase the concentration of Verzenio in the blood, potentially leading to increased side effects.
- Watch for Signs of Infection: Due to the risk of neutropenia (low white blood cell count), patients should be vigilant for signs of infection, such as fever or flu-like symptoms, and seek medical advice promptly if they occur.
- Lung Health Monitoring: Since Verzenio can cause severe lung problems, patients experiencing new or worsening respiratory symptoms should report these to their healthcare provider immediately.
- Heart Health: Patients with a history of heart disease should discuss the potential risks with their healthcare provider, as some side effects of Verzenio, like blood clots, can impact heart health.
What Are the Contraindications of Verzenio?
Verzenio has specific contraindications that should be considered before initiating treatment to ensure it is used safely and effectively:
- Allergy to Abemaciclib or Any Component: Patients with a known hypersensitivity to abemaciclib or any formulation component should not use Verzenio. This includes any severe allergic reactions that have occurred previously.
- Pregnancy: Verzenio tablet is contraindicated in pregnancy due to the danger it poses to the developing fetus in the mother. Animal studies have shown harm to the fetus, and the drug is believed to have the potential to cause similar effects in humans. Women of reproductive potential should have a confirmed negative pregnancy test before starting Verzenio and should use effective contraception during treatment & for some time after the last dose.
What If You Missed a Dose of Verzenio?
If you miss a dose of Verzenio (abemaciclib), take it as soon as you remember. However, if it’s close to the time for your next scheduled dosage, skip the missed dose of Verzenio and resume your usual dosing schedule. Do not take two doses of this medication to make up for a missed dose. Missing a dose of Verzenio can impact the effectiveness of the treatment regimen, so it’s important to take Verzenio exactly as prescribed. Setting reminders or alarms can help you maintain the dosing schedule. If you frequently miss doses, discuss this with your healthcare provider, as they may have suggestions or adjustments to help you better manage the treatment schedule.
[Note: If you have missed a dose of Verzenio and are unsure regarding the next one, immediately consult your doctor or pharmacist.]
What Happens If You Take Too Much of Verzenio?
Taking too much Verzenio (abemaciclib) can lead to an overdose, which may exacerbate its associated side effects and potentially lead to severe adverse reactions. Common side effects like diarrhea, neutropenia, and liver enzyme elevation could become more severe and dangerous. In the event of an overdose, it is crucial to seek immediate medical attention. Medical experts may need to provide supportive care, including interventions to manage severe diarrhea, monitoring and possibly countering low white blood cell counts, and addressing any liver or lung complications that arise. There is no specific antidote for Verzenio overdose, so treatment is symptomatic and supportive. Ensuring proper medical supervision and adhering strictly to the prescribed dosage are essential for preventing overdose risks.
[Note: If you have consumed more than the recommended dose of Verzenio, get medical help right away or call the Poison Help line at 1-800-222-1222.]
How to Store a Verzenio?
To ensure the effectiveness and safety of Verzenio (abemaciclib), it’s important to store the medication properly by following these guidelines:
- Temperature: Store Verzenio tablets at room temperature, between 20°C & 25°C. Avoid exposing the medication to extreme temperatures, such as those found in cars during hot or cold weather.
- Humidity: Keep Verzenio in a dry place. Avoid storing it in moisture-prone areas, such as bathrooms or near sinks.
- Original Packaging: Keep Verzenio in its original container to protect it from light & moisture. The container is often designed to maintain the medication’s stability.
- Keep the Container Tightly Closed: Ensure the container is tightly closed after each use to protect the medication from moisture and air.
- Keep out of Reach of Children and Pets: Store Verzenio out of the reach and sight of children & pets to prevent accidental ingestion.
- Avoid Contamination: Do not touch the pills with wet hands, as this could affect the integrity of the medication.
[Note: By adhering to these storage recommendations, you can help maintain the quality & effectiveness of Verzenio throughout its intended shelf life. Always refer to the storage instructions on the medication label and consult your pharmacist with any questions about storing your medication properly.]
What Medications Interact with Verzenio?
Verzenio (abemaciclib) is a medication used primarily in the treatment of certain types of breast cancer. It can interact with various other medications, potentially affecting how well Verzenio or the other medications work or increasing the danger of side effects. Here are some key interactions:
- Strong CYP3A4 Inhibitors: These medications can significantly increase the levels of Verzenio in the blood, enhancing the risk of side effects such as diarrhea, neutropenia, and liver enzyme elevations. When taken together, your doctor may adjust the Verzenio dose or recommend avoiding these inhibitors. Examples include:
- Ketoconazole: An antifungal that strongly inhibits the CYP3A4 enzyme, increasing Verzenio’s concentration in the body.
- Clarithromycin: An antibiotic that raises Verzenio levels by blocking its breakdown.
- Itraconazole: Another antifungal that slows Verzenio metabolism, leading to higher drug exposure.
- Lopinavir/ritonavir: HIV medications that increase Verzenio levels due to their enzyme-inhibiting properties.
- Posaconazole and Voriconazole: Antifungals that reduce Verzenio clearance, heightening the chance of side effects.
- Telithromycin: A macrolide antibiotic that interacts by inhibiting Verzenio metabolism.
- Nefazodone: An antidepressant that can lead to elevated Verzenio concentrations.
- Grapefruit and Grapefruit Juice: Inhibit CYP3A4 enzymes in the liver and intestine, which increases Verzenio’s systemic levels.
- Strong CYP3A4 Inducers: These medications can decrease Verzenio’s effectiveness by speeding up its metabolism, and reducing drug levels in the bloodstream. Doctors may advise against using these drugs together or may alter the Verzenio dose. Examples include:
- Rifampin: A tuberculosis medication that accelerates Verzenio clearance, lowering its efficacy.
- Phenytoin: An anticonvulsant that significantly decreases Verzenio levels by inducing its breakdown.
- Carbamazepine: Commonly used for seizures, this medication reduces Verzenio effectiveness through enhanced metabolism.
- St. John’s Wort: A herbal supplement known to induce CYP3A4, thereby decreasing Verzenio concentrations and therapeutic effects.
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- Anticoagulants: Verzenio can increase the risk of bleeding when used with blood-thinning medications like warfarin. This interaction occurs because Verzenio may disrupt the balance of clotting factors or intensify the anticoagulant’s effect.
- P-glycoprotein (P-gp) Substrates: Verzenio may increase the exposure of medications transported by P-glycoprotein, a protein involved in drug elimination. Elevated levels of these drugs can lead to toxicity. Examples include:
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- Digoxin: Verzenio increases digoxin levels, raising the risk of cardiac side effects like arrhythmias.
- Dabigatran: A blood thinner that can accumulate when combined with Verzenio, heightening the risk of severe bleeding.
[Note: Patients should always inform their healthcare expert of all medications they are taking, including prescription drugs, over-the-counter medications, and herbal supplements, to manage potential interactions effectively.]
What Are the Other Verzenio Interactions?
In addition to the previously mentioned interactions involving potent CYP3A inhibitors and inducers, grapefruit products, and anticoagulants, Verzenio (abemaciclib) may have other potential interactions to consider:
- Drugs Affecting Gastric pH: Medications that alter the stomach’s pH, such as proton pump inhibitors (PPIs), H2 antagonists, and antacids, could affect Verzenio’s absorption. However, detailed clinical data on this is limited, so it’s important to consult a healthcare provider.
- Certain Antibiotics and Antifungals: In addition to potent CYP3A inhibitors, other antibiotics, and antifungals may also moderately affect Verzenio’s metabolism and should be used cautiously.
- Hormonal Contraceptives: Since Verzenio can increase the risk of forming blood clots, combining it with hormonal contraceptives, which can also increase clotting risk, should be approached with caution.
- Blood Pressure Medications: Verzenio can cause hypertension in some patients. Using it with blood pressure medications may require adjustments and close monitoring by healthcare specialists.
- Immunosuppressants: These drugs could interact with Verzenio by affecting immune system responses, especially considering Verzenio’s impact on white blood cell counts.
- Diuretics: As Verzenio can affect liver enzymes and potentially the kidneys, using it alongside diuretics may warrant additional monitoring for kidney function.
[Note: Patients should always inform their medical professional of all medications they are taking, including prescription drugs, over-the-counter medications, and herbal supplements, to manage potential interactions effectively.]
What Are the Verzenio Alternatives?
Verzenio Alternatives include a range of treatments for breast cancer, especially for hormone receptor-positive or HER2-positive types. Some common alternatives are:
- Ibrance (palbociclib)
- Kisqali (ribociclib)
- Femara (letrozole)
- Arimidex (anastrozole)
- Aromasin (exemestane)
- Faslodex (fulvestrant)
- Tamoxifen (various brand names)
- Xeloda (capecitabine)
- Herceptin (trastuzumab) – for HER2-positive breast cancers
- Perjeta (pertuzumab) – often used in combination with Herceptin
- Lynparza (olaparib) – for BRCA-mutated breast cancers
- Talzenna (talazoparib) – for BRCA-mutated breast cancers
[Note: Your doctor will choose the best alternative for you. Don’t use any of the medications mentioned above without consulting your healthcare expert. Taking them by yourself may cause serious side effects.]
Verzenio Cost & Coupons
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Frequently Asked Questions
Is Verzenio tablet considered chemotherapy?
No, Verzenio is not classified as chemotherapy. It is a targeted therapy that works differently from traditional chemotherapy. While chemotherapy targets and kills rapidly dividing cells, including cancer cells, Verzenio specifically inhibits certain enzymes known as cyclin-dependent kinases (CDKs). This action helps to slow down the uncontrolled growth of cancer cells without directly killing them, making it a more targeted approach to cancer treatment.
Is Verzenio considered immunotherapy?
No, Verzenio is not an immunotherapy; it is categorized as a targeted therapy. Unlike immunotherapy, which enhances the body’s immune system to detect and destroy cancer cells, Verzenio targets explicitly and inhibits specific proteins involved in cell growth, namely cyclin-dependent kinases (CDKs). This action helps slow cancer cell proliferation by engaging the immune system.
How long is treatment with Verzenio typically required?
The duration of treatment with Verzenio depends on the stage of breast cancer being treated. For early-stage breast cancer, the usual course is about two years, although this may vary if the medication is not well tolerated or if the cancer recurs. In cases of advanced or metastatic breast cancer, treatment is often extended and continues until the medication is no longer tolerated or the tumor progresses. The duration is tailored to each patient’s situation, and the oncology team makes decisions. It is important not to discontinue Verzenio without consulting your oncologist.
Can Verzenio cause weight gain?
Clinical studies involving Verzenio (abemaciclib) did not commonly report weight gain as a side effect. In research examining the impact of Verzenio combined with endocrine therapy for breast cancer, most participants did not experience significant changes in weight after 18 months of treatment. In fact, weight loss was more frequently observed than weight gain. If you have any concerns about weight changes while taking Verzenio, it’s important to discuss them with your oncology care team.
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