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

Patients with ER+/HER2- metastatic breast cancer who harbor ESR1 mutations face distinct challenges that contribute to poorer outcomes. These mutations drive endocrine resistance, limiting the effectiveness of aromatase inhibitors and necessitating alternative strategies. While newer oral SERDs and targeted agents offer promise, access, sequencing guidance, and long-term data remain limited. Additionally, there is a need for therapies that more effectively overcome or prevent resistance mechanisms while maintaining tolerability for long-term disease management. Improved clinical decision-making tools, clearer guidelines on integrating novel therapies, and more research in diverse patient populations are essential. Addressing these gaps will help personalize treatment, extend disease control, and ultimately improve outcomes for this growing patient subgroup.