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Elacestrant Usage in ER+/HER2- Metastatic Breast Cancer: Clinical Guidelines and Patient Profiles

Opinion
Video

Experts discuss how they determine whether a patient with metastatic breast cancer is a candidate for treatment with elacestrant based on FDA approved indication, NCCN guidelines, and the results of ESR1 mutation and resistance marker testing. Participants also discuss how they determine treatment failure or resistance.

This is a video synopsis/summary of a Peer Exchange featuring Mabel Mardones, MD; Rena Callahan, MD; William Gradishar, MD; and Gregory Vidal, MD, PhD.

Mardones discusses the clinical use of oral selective estrogen receptor degraders (SERDs) with Callahan and Vidal. Callahan follows guidelines, using elacestrant in second- or third-line settings for patients with prior CDK4/6 inhibitor therapy and ESR1 mutations. They consider patient preferences for oral therapies and discuss potential broader use.

Mardones and Callahan explore secondary resistance, emphasizing ESR1 mutations and prior CDK4/6 inhibitor therapy duration as markers for optimal elacestrant outcomes. Regarding treatment failure, both doctors stress relying on disease progression observed in scans and clinical indicators for timely therapy adjustments.

This dialogue provides practical insights into incorporating oral SERDs into clinical practices, considering guidelines and individual patient factors.

Video synopsis is AI-generated and reviewed by AJMC® editorial staff.

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