Advancements in Treatment Offering Hope
- Late-stage or metastatic breast cancer that has spread beyond the breast with ESR1 mutations can be challenging to treat. These types of mutations are present in up to 40 percent of ER+, HER2- metastatic breast cancers.
- A growing class of medications called selective estrogen receptor degraders (SERD) are designed to treat these types of breast cancer. They work by blocking and destroying hormone (estrogen) receptors on breast cancer cells, which ultimately prevents cancer growth.
- The Food and Drug Administration has already approved Elacestrant (Orserdu), and other SERD drugs, such as Vepdegestrant, are still undergoing clinical trials.
- Clinical trials help doctors better understand cancer and discover more effective treatment methods. They also allow patients to try a treatment before it’s approved by the U.S. Food and Drug Administration (FDA), which can potentially be life-changing.
- Despite the great benefits of clinical trials, they also come with risks (like potential side effects that are not fully understood yet). People interested in participating in clinical trials must first talk with their doctor to see if they would be a good fit.
- For help finding a clinical trial that’s right for you, try our easy-to-use Clinical Trial Finder.
Women with breast cancer at later stages are often told that estrogen receptor-positive is challenging to treat. However, a growing number of treatment options are becoming available, offering patients much-needed hope. Elacestrant (tradename: Orserdu) is a Food and Drug Administration (FDA) approved medication tailored especially for these types of cancers.
“We are in the midst of a new revolution in anti-estrogen therapies where we have a number of medicines currently under clinical development,” Dr. Seth Wander, medical oncologist at Massachusetts General Hospital and Harvard Medical School, tells SurvivorNet.
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Dr. Wander says it’s too soon to know how Vepdegestrant compares to currently available drugs such as Elacestrant.
“We’re in the process of determining that we have a number of clinical trials with phases one and two, and what we’re talking about today is the VERITAC-3 study, which is a phase three study, meaning it’s a large randomized study pairing this agent the Vepdegestrant combination with an SD4K inhibitor Palbociclib to the current standard of care which would be an aromatase inhibitor – which is currently available,” Dr. Wander adds.
So far, side effects presented in clinical trial participants may include menopausal-type symptoms and fatigue. Researchers closely monitor white blood cell counts to determine if dosage combinations cause any significant impact.
Helping Patients Understand Treatment Options for Breast Cancer
- Elacestrant (Orserdu) Offers Hope for Patients With a Stubborn Form of Metastatic Breast Cancer
- Advances in Metastatic Breast Cancer Treatments Over the Last Year Offer New Hope for Those Fighting
- Do You Have HER2-Positive Metastatic Breast Cancer? Here’s A Breakdown Of Some Of Your Treatment Options
- HER2-Positive Metastatic Breast Cancer Treatment Options Explained
- Metastatic Triple-Negative Breast Cancer Treatments To Consider
Determining the Best Approach to Treatment
Breast cancer cells contain proteins on their surface, contributing to their growth and progression. The most important of these proteins are the estrogen receptor (ER), progesterone receptor (PR), and the human epidermal growth factor-2 (HER2). The first two, ER and PR, bind the hormones estrogen and progesterone, respectively. If cancer cells carry both proteins on their surface, the cancer is called hormone receptor-positive (HR+).
Advanced and metastatic cases of such cancers are treated with hormone (also called endocrine) therapies, such as Tamoxifen. Tamoxifen binds to ERs, preventing it from interacting with estrogen. This prevents the breast tumor cells from growing and multiplying. HER2 protein also contributes to rapid breast cancer growth. Cancers with high levels of HER2 tend to be more aggressive. However, they can be specifically and effectively targeted by drugs such as Herceptin. This generally makes the cancers that lack HER2, so-called HER2-negative, the more clinically dangerous cancers.
Estrogen Receptor Degrader SERD Breast Cancer Treatment
As we previously mentioned, Elacestrant is among the medications available that work to prevent estrogen from interacting with the receptor and fueling cancer growth.
“The survival data are still immature,” Dr. Sylvia Adams, Director of the Breast Cancer Center at NYU’s Perlmutter Cancer Center, told SurvivorNet. “But we do have progression-free survival data showing that there is definitely benefit to using these newer agents compared to what the standard used to be before.”
Other drugs in this class, such as AstraZeneca’s Camizestrant, have shown great promise in recent clinical trials. AstraZeneca pioneered SERDs after gaining approval for faslodex in 2002. Faslodex, however, is given via an intramuscular injection. Elacestrant is taken orally, which makes it an arguably more convenient drug than faslodex.
Advancements in Metastatic Breast Cancer Treatment Adds Value to Clinical Trials
The SERD class of drugs is a byproduct of clinical trials, which are studies of new forms of treatment. These trials are helpful in medicine for two reasons:
Clinical trials help doctors better understand cancer and discover more effective treatment methods.
They also allow patients to try a treatment before it’s approved by the U.S. Food and Drug Administration (FDA), which can potentially be life-changing.
WATCH: Clinical trials can be lifesaving.
Dr. Beth Karlan is a gynecologic oncologist at UCLA Health. She says the goal with clinical trials is to advance cancer research to a point where the disease becomes akin to diabetes, where it becomes a manageable condition.
“Clinical trials hopefully can benefit you, but they also provide vital information to the whole scientific community about the effectiveness of these treatments,” Dr. Karlan said.
“They can be lifesaving. In the last few years, we’ve seen many children and adults who have participated in trials and had miraculous results,” Dr. Karlan continued.
If you want to participate in a clinical trial, your first step should be to talk with your doctor. They can address many of your initial questions and help determine whether you would be a good participant.
Another crucial part of clinical trials is finding the right one for you. SurvirorNet has a resource to help with this called the Clinical Trial Finder.
Learn more about SurvivorNet's rigorous medical review process.
