Elacestrant vs Standard Endocrine Therapy for ER+/HER2− Advanced Breast Cancer
Journal of Clinical Oncology
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"This phase III trial demonstrated progression-free survival benefits with elacestrant versus standard-of-care endocrine therapy in patients with previously treated (including with CDK4/6 inhibitors), estrogen receptor–positive, human epidermal growth factor receptor 2–negative advanced breast cancer (ER+/HER2− ABC). Elacestrant also showed efficacy in patients with ESR1–mutant breast cancer.
Elacestrant has a tolerable toxicity profile. It is a promising endocrine therapy option after progression on first-line treatment with CDK4/6 inhibitors in ER+/HER2− ABC."
– Jing Xi, MD, MPH
Written by
Hazelgreen
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Yay for oral SERDs! They are great. The problem is that the time to failure is short. I was on another one in another clinical trial. At 6 months, no cancer and no side effects. At 13 months, new tumor so switched treatment. I wonder what the long term will show about this one. I think longevity is the general problem with them. But I had one great year. MSK oncologist said I got a relatively long ride.
It’s being compared to the current standard of care (SOC) 2nd/3rd line treatment of MBC. The study was randomized, so approximately half of treated patients with elacetrant and the other half received fulvestrant. Hope it helps.
Thanks for this info! Those of us with E+ her2neu- mbc often do well for much longer than the median survival that's often quoted. But as a long timer (18 years +) with mbc, I've only been on two meds that weren't available when I was diagnosed with denovo mbc in 2004--Xgeva and Ibrance. Ibrance damaged my lungs very quickly. I switched from Zometa to Xgeva for my bone mets almost as soon as it becdame FDA approved as I was allergic to Zometa and had a complicated routine for receivin g it--half dose, IV benedryl and hydrocortizone first, and a two hour infusion time rather than the usual 20 minutes, I got nearly 5 years from Letrozole and then over 9 years from Faslodex. And now I've been on Exemestane for about 4 1/2 years. Those were the standard of care treatments when I was diagnosed. I know I'm very fortunate to have done so well for so long. (does anybody here have a clue why my keyboard suddenly switched to italics and what I can do to stop it if it happens again? I am certainly no techie! LOL). I've met several women who lived longer than I have3 with MBC, one for 30 years! I wish there were some way I could share whatever it is about my cancer cells than allow them to be managed so well, especially with women who still have children who need them! And I wish some scientist would discover whatever it is that needs to be known to get rid of all cancers!
That is amazing--your whole journey! Nine years on Faslodex! Why did you go from Faslodex to exemestane? And I assume you have not been taking the CDK 4,6 inhibitors? Were you oligometastatic? Thanks! Kay
I'm not sure what oligometastatic means. I had "extensive" bone mets (spine, pelvis, scapula, rib) when first diagnosed, but no symptoms. I have lobular bc, which often migrates to "odd" places. About two years ago it showed up in a ureter, and then not quite a year ago two tiny spots on the right cerebellum. I switched from Faslodex to Exemestane due to progression, but only after we'd (onc and me) watched it awhile and it was slow but kept on creeping along. I did have Foundation 1 testing done.
You are a real survivor! I have trouble understanding all the drugs and treatments and following all the science but I do feel hopeful when I hear from lovely ladies like you. Is there something else that you do to make the drugs work for you. Do you walk a mile a day etc. Just wondering and hoping that you have a secret weapon that we can learn from your good survivor rate. I wish you many many more years of health. Hugs M.
I'm afraid my "secret weapon" is probably genetic. Several members of my dad's side of my family have also done exceptionally well with advanced cancers, no other bc, and both my onc and genetics counselor think we must carry some gene that doesn't prevent us from getting cancer but helps control cancer cells once we have cancer, My paternal grandmother was successfully treated for endometrial cancer in the 1950s when shhe was in her 70's, and my only first cousins on that side of my family both had advanced colon cancer and did much better than espected. My father also had prostate cancer and did very well with it, even after a major stroke. I've tried to find ways to have my genes tested to see if what it is we have can be figured out and possibly replicated....if anybody has ideas about how to get that done, please let me know!
Thanks PJ! Oligo is "few"--so only a few tumors. Interesting drug progression. Have you also been taking the CDK 4,6 inhibitors? I had heard form others that lobular was a bit tricky to handle. Good for you for lasting so long on these drugs!
Thank you so much for posting!Just was to add that the drug was developed by small US biotech (Radius Health) and Italian Menarini Group.
The drug was already submitted to the FDA with accelerated review requested. If accepted, FDA review will be shortened to 8 month. I hope that the drug will be approved deprive lack of statistical significance.
Yes, good news for all of these 'promising' new drugs. The ones that are to work the best are getting sidelined, like ErSo and the other new one that was metnioned here a week or so ago. Covid vaccine was fast tracked with less than 1.5 years. Surely, a cancer med like Erso, which I will add has the MOST promising news, killing all the cancer cells, leave the good cells and does not return, what more could we all hope for?! Mind boggeling to think we are in 2022 and cancer still has not been erradicated. Right?
Hi Cindy--Thank you so much for finding these articles and posting! I was hoping the new oral SERDs would be the way to go--too bad they are rather short-lived. But that would give us some time at least while new drugs come out--hopefully. I hope that approve it. Kay
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