Women with advanced hormone receptor positive (HR+) breast cancer who progress on endocrine therapy, CDK4/6 inhibition, and chemo often exhibit endocrine resistance. Elacestrant is an oral, selective estrogen receptor degrader. In the randomized phase 3 EMERALD trial, patients with advanced, progressive HR+ breast cancer were randomized to continued endocrine monotherapy or elacestrant. Nearly half of patients (48%) had ESR1 mutations, which result in estrogen-independent ER-activation. Elacestrant reduced the risk of progression or death by 30% overall and 45% among those with ESR1 mutation. | Bidard, J Clin Oncol 2022


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