Kirollos Hanna, PharmD, BCPS, BCOP, FACCC, FAPO

Patients with longer prior ET plus CDK4/6 inhibitor exposure showed the greatest benefit from elacestrant, confirming its value in endocrine-sensitive, ESR1-mutated tumors.

Among chemotherapy-naive patients, elacestrant extended median progression-free survival compared with standard therapy, particularly in ESR1-mutated cases.

Elacestrant significantly improved progression-free survival and maintained a manageable safety profile, especially benefiting patients with ESR1-mutated tumors.

The phase 3 randomized trial enrolled 694 patients with ER+/HER2– disease, stratified by ESR1 mutation status and prior therapies, to compare elacestrant versus standard-of-care endocrine treatments.

As resistance to endocrine and CDK4/6 inhibitor therapy grows, elacestrant offers a promising targeted option for patients with ESR1 mutations driving treatment failure.

The EMERALD trial evaluated elacestrant, an oral SERD, as a potential new standard for patients with ER+/HER2– advanced breast cancer resistant to prior endocrine therapies.