Verzenio Has Shown Substantial Efficacy in Liposarcoma
Verzenio (abemaciclib, Eli Lilly) has been a blockbuster in breast cancer for several years now; a title it initially earned after only 4 years on the market. Recent data put out by Clival places Verzenio as 6th among all oncology drugs in 2025 sales, with all of its sales being in HR+, HER2- breast cancer. [1]
CDK 4/6 inhibitors have also shown promise in liposarcoma, a malignancy with an incidence that is a fraction of HR+, HER2- breast cancer. There has long been evidence to suggest CDK 4 amplification is present in up to 90% of all liposarcoma patients. [2] As of this past May, we now have phase III evidence from the SARC041 trial that CDK 4 is highly actionable in these patients. SARC041 was an investigator-initiated trial that compared Verzenio to placebo in advanced dedifferentiated liposarcoma. Around half of these patients were treatment-naïve in the advanced setting, with the rest having already received at least one line of chemotherapy. The mainstay chemotherapy at first line (1L) is single-agent doxorubicin, a fact that hasn’t changed for several decades. Despite multiple efforts, there has never been a targeted agent approved in this malignancy.
Among treatment-naïve patients, Verzenio achieved a staggering 16.4 months in progression-free survival, a number that is a near perfect match to our projection for the expected 1L overall survival on single-agent doxorubicin, when controlling for cross-trial differences. [3, 4] This amounts to a 78% improvement in trial-adjusted progression-free survival when compared to doxorubicin. While overall survival was not yet reached, a very conservative estimate places Verzenio at 16.2% Clinical Innovation over doxorubicin, a score that is indicative of a likely market-dominator. (Figure 1) With a safety and convenience benefit being added as well, Verzenio’s efficacy far outweighs the increased cost in Equinox’s Unmet Need framework.
Figure 1: Drivers of Clinical Innovation for Verzenio vs doxorubicin
[1] Clival Database. 10 best-selling cancer drugs by estimated global sales (2025-2026). Clival. April 30, 2026. Accessed October 19, 2026. https://clival.com/blog/10-best-selling-cancer-drugs-by-estimated-global-sales-2025-2026
[2] Assi T, Kattan J, Rassy E, et al. Targeting CDK4 (cyclin-dependent kinase) amplification in liposarcoma: A comprehensive review. Crit Rev Oncol Hematol. 2020;153:103029. doi:10.1016/j.critrevonc.2020.103029
[3] Doherty K. Abemaciclib produces first positive phase 3 trial results in dedifferentiated liposarcoma. OncLive. May 31, 2026. Accessed October 19, 2026. https://www.onclive.com/view/abemaciclib-produces-first-positive-phase-3-trial-result-in-dedifferentiated-liposarcoma
[4] Schöffski P, Sanfilippo R, Martin-Broto J, et al. Brigimadlin versus doxorubicin in advanced dedifferentiated liposarcoma: efficacy, safety, and translational data from Brightline-1, a randomized phase II/III trial. Clin Cancer Res. Published online June 30, 2026. doi:10.1158/1078-0432.CCR-26-0509