Dr. Gandhi and Dr. Clifton discuss the evolving role of oral selective estrogen receptor degraders (SERDs) in the treatment paradigm for hormone receptor–positive/HER2-negative (HR+/HER2–) breast cancer, considering patient characteristics, clinical scenarios, and the landscape of approved and investigational agents, including elacestrant, imlunestrant, and camizestrant.
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With the emergence of oral SERDs, how do you see their role evolving in the treatment paradigm? What patient characteristics or clinical scenarios make you more likely to consider SERD therapy?
Please briefly highlight the landscape of oral SERDs, including approved and investigational agents in the pipeline:
Elacestrant
Imlunestrant
Camizestrant
Any others
What are your thoughts on implementing serial ESR1 mutation monitoring to guide earlier treatment changes? Do you see value in this proactive approach vs waiting for clinical/radiographic progression?
If novel agents show efficacy in both patients with ESR1-mutated disease and those with wild-type disease, do you anticipate ESR1 mutation status will remain as critical a biomarker for oral SERD use as we’re seeing with elacestrant?