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Opinion|Videos|November 13, 2025

Subgroup Analysis of Patients With No Prior Chemotherapy in EMERALD Trial

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

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

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

A focused analysis of chemotherapy-naive patients revealed elacestrant’s superior efficacy, demonstrating a median PFS of 3.7 months vs 2.0 months for standard of care in all patients. Among those with ESR1-mutated tumors, elacestrant extended median progression-free survival to 5.3 months vs 1.9 months for standard of care. These findings highlight elacestrant’s particular benefit in patients who have not yet received chemotherapy.

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