Elacestrant in the treatment landscape of ER-positive, HER2-negative, ESR1-mutated advanced breast cancer: a contemporary narrative review

被引:0
作者
Qureshi, Zaheer [1 ]
Jamil, Abdur [3 ]
Altaf, Faryal [5 ]
Siddique, Rimsha [4 ]
Adilovic, Edin [2 ]
Fatima, Eeshal [6 ]
Shah, Shivendra [7 ]
机构
[1] Quinnipiac Univ, Frank H Netter MD Sch Med, Hamden, CT USA
[2] St Vincent Mercy Med Ctr, Bridgeport, CT 06606 USA
[3] Samaritan Med Ctr, Dept Med, New York, NY USA
[4] Independent Res Associate, Watertown, NY USA
[5] Icahn Sch Med Mt Sinai, BronxCare Hlth Syst, Dept Internal Med, New York, NY USA
[6] Serv Inst Med Sci, Dept Med, Lahore, Pakistan
[7] Nepalgunj Med Coll, Dept Med, Chisapani 00977, Nepal
来源
ANNALS OF MEDICINE AND SURGERY | 2024年 / 86卷 / 08期
关键词
advanced breast cancer; elacestrant; ESR1; mutation; estrogen receptor-positive; HER2-negative; selective estrogen receptor degrader; ESTROGEN-RECEPTOR DEGRADER; ENDOCRINE THERAPY; ESR1; MUTATIONS; COLLABORATIVE REANALYSIS; ANTITUMOR-ACTIVITY; FAMILY-HISTORY; SEX-HORMONES; RAD1901; FULVESTRANT; WOMEN;
D O I
10.1097/MS9.0000000000002293
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction:Estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2-) breast cancer with ESR1 mutations presents a significant therapeutic challenge due to its adaptive resistance mechanisms to chemotherapy, especially endocrine treatment. Elacestrant, a novel oral selective estrogen receptor degrader (SERD), has emerged as a promising agent in this treatment-resistant era.Method:A comprehensive search was conducted on pivotal clinical trials, including the RAD1901-005 Trial, EMERALD TRIAL, ELIPSE, and ELEVATE, focusing on their methodologies, patient populations, treatment regimens, and outcomes.Discussion:This narrative review describes the available preclinical and clinical evidence on elacestrant, focusing on its pharmacodynamics, pharmacokinetics, efficacy, and safety within the existing literature. Elacestrant has demonstrated excellent activity against ESR1 mutations associated with resistance to first-line endocrine therapies. Clinical trials have shown improved progression-free survival in patients with advanced ER+/HER2-, ESR1-mutated breast cancer. Safety profiles indicate a tolerable side effect spectrum consistent with other agents. Its oral bioavailability offers a convenient alternative to injectable SERDs, with potential implications for patient adherence and quality of life. The review also discusses the comparative efficacy of elacestrant relative to existing endocrine therapies and its possible use in combination regimens.Conclusion:Ongoing clinical trials assessing elacestrant and other SERDs will yield data that might aid clinicians in determining the optimal selection and order of endocrine treatment drugs for ER+ breast cancer. The integration of targeted and immunotherapeutic agents with traditional chemotherapy represents a pivotal shift in Breast Cancer treatment, moving towards more personalized and effective regimens.
引用
收藏
页码:4624 / 4633
页数:10
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