In this animated video, Prof. Javier Cortés sheds light on the phase 3 EMERALD trial subgroup analyses and explores how these findings may inform clinical decision-making in the 2nd line setting, following ET + CDK4/6i therapy, for patients with ESR1-mutated tumors.

 

Key topics include: 

  • Identifying tumors that remain endocrine-sensitive despite acquired resistance to previous ET 
  • Discussion of subgroup analyses results and their implications for clinical practice
  • A review of alternative 2nd line treatment options 

 

Watch the video above and download the accompanying slides for more details.

 

Clinical takeaways

  • Elacestrant provides clinically meaningful improvements in PFS for patients with ER+/HER2- mBC who received at least 12 months of ET+CDK4/6i in 1st line and whose tumors harbor ESR1-mut  
  • The PFS benefit associated with elacestrant was consistent across clinically relevant subgroups, including tumors harboring coexisting ESR1 and PIK3CA-mut, indicating that disease progression after ET + CDK4/6i in this subgroup may remain ER-driven 
  • Safety analyses demonstrated that elacestrant had a manageable safety profile similar to other ETs and without evidence of some of the toxicities associated with other drug classes, such as CDK4/6i and PI3K/AKT/mTOR inhibitors
  • ESR1-mut testing should be done at 1st line progression via liquid biopsy due to disease subclonality; if negative, repeat at each progression. Archival tissue should not be used for testing due to the acquired nature of ESR1-mut  

Head of the International Breast Cancer Centre (IBCC) in Barcelona, founding partner of Medica Scientia innovation Research (MedSIR), a company involved in the clinical development of clinical trials. Member of the Scientific Committee of the ESMO and EBCC.

Prof. Javier Cortés has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

Roche , AstraZeneca, Seattle Genetics, Daiichi Sankyo, Lilly, Merck Sharp & Dohme, Leuko, Bioasis, Clovis Oncology, Boehringer Ingelheim, Ellipses, Hibercell, BioInvent, Gemoab, Gilead, Menarini, Zymeworks, Reveal Genomics, Scorpion Therapeutics, Expres2ion Biotechnologies, Jazz Pharmaceuticals, Abbvie, BridgeBio, Biontech, Biocon, Circle Pharma, Delcath Systems, Roche, Novartis, Eisai, Pfizer, Lilly, Merck Sharp & Dohme, Daiichi Sankyo, Astrazeneca, Gilead, Stemline Therapeutics.

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