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Opinion|Videos|November 20, 2025

Subgroup Analysis From the Phase 3 EMERALD Trial by Prior Duration of Endocrine Therapy Plus CDK4/6 Inhibitor

Author(s)Daphne Stewart, MD, Kirollos Hanna, PharmD, BCPS, BCOP, FACCC, FAPO

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

Episodes in this series

EP. 1 Introducing the EMERALD Trial

EP. 1 Introducing the EMERALD Trial

EP. 2 Examining Therapies Used in Later Lines of Treatment in ER+/HER2- Metastatic Breast Cancer

EP. 2 Examining Therapies Used in Later Lines of Treatment in ER+/HER2- Metastatic Breast Cancer

EP. 3 Unmet Needs in Patients with ER+/HER2- Metastatic Breast Cancer with an ESR1 Mutation

EP. 3 Unmet Needs in Patients with ER+/HER2- Metastatic Breast Cancer with an ESR1 Mutation

EP. 4 Treatment Sequencing of ER+/HER2- Metastatic Breast Cancer and the Associated Healthcare Resource Utilization and Overall Cost of Care

EP. 4 Treatment Sequencing of ER+/HER2- Metastatic Breast Cancer and the Associated Healthcare Resource Utilization and Overall Cost of Care

EP. 5 Emerald Trial Study Design Strengths and Limitations

EP. 5 Emerald Trial Study Design Strengths and Limitations

EP. 6 Baseline Characteristics of the Emerald Trial and the Importance of an ESR1 Mutation

EP. 6 Baseline Characteristics of the Emerald Trial and the Importance of an ESR1 Mutation

EP. 7 Additional Baseline Characteristics and Their Relevance to Clinical Practice

EP. 7 Additional Baseline Characteristics and Their Relevance to Clinical Practice

EP. 8 Evaluating Efficacy and Safety Data from the EMERALD Trial

EP. 8 Evaluating Efficacy and Safety Data from the EMERALD Trial

EP. 9 Implications of the EMERALD Study for Patients, Providers, and Payers

EP. 9 Implications of the EMERALD Study for Patients, Providers, and Payers

EP. 10 Subgroup Analysis of Patients With No Prior Chemotherapy in EMERALD Trial

EP. 10 Subgroup Analysis of Patients With No Prior Chemotherapy in EMERALD Trial

EP. 11 Subgroup Analysis From the Phase 3 EMERALD Trial by Prior Duration of Endocrine Therapy Plus CDK4/6 Inhibitor

EP. 11 Subgroup Analysis From the Phase 3 EMERALD Trial by Prior Duration of Endocrine Therapy Plus CDK4/6 Inhibitor

EP. 12 Beyond the Primary End Point: Diving Deeper Into the EMERALD trial | Written Recap

EP. 12 Beyond the Primary End Point: Diving Deeper Into the EMERALD trial | Written Recap

An additional subgroup analysis examined outcomes based on prior endocrine therapy (ET) duration and CDK4/6 inhibitor exposure. Patients with a longer prior duration of ET plus CDK4/6 inhibitor showed a clinically meaningful improvement in PFS when treated with elacestrant compared to standard of care. This suggests that tumors retaining partial endocrine sensitivity particularly with ESR1 mutations—derive the greatest benefit from selective estrogen receptor degrader-based therapy.

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