SERD vs investigator’s choice of endocrine monotherapy for ER+/HER2-advanced/mBC

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Published: 22 Dec 2021
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Dr Aditya Bardia - Mass General Cancer Center, Boston, USA

Dr Aditya Bardia speaks to ecancer about the results of EMERALD phase 3 trial. The study investigated elacestrant, an oral selective oestrogen receptor degrader (SERD), vs investigator’s choice of endocrine monotherapy for ER+/HER2-advanced/metastatic breast cancer (mBC) following progression on prior endocrine and CDK4/6 inhibitor therapy.

He says to understand how elacestrant compares to the current standard –of care, Dr Bardia and his colleagues initiated the phase III EMERALD trial, making elacestrant the first oral SERD to be studied in a randomised phase III clinical trial. Dr Bardia explains the methodology and key results of this trial.

He found that patients in the elacestrant arm had a 30 percent lower risk of death or disease progression compared with those in the standard-of-care arm. Among patients whose tumours had ESR1 mutations, those in the elacestrant arm had a 45 percent reduced risk of death or disease progression.

He says that the subgroup analyses showed that elacestrant improved outcomes regardless of the presence of visceral metastases, the number of prior lines of therapy, pretreatment with fulvestrant, or geographic region. Dr Bardia concludes by discussing how the results from this trial can impact the future treatment of this type of breast cancer.