Elacestrant is a non-steroidal small molecule and an estrogen receptor (ER) antagonist.[A256838,L44918] In January 2023, it was approved by the FDA for the treatment of ER-positive, HER2-negative, ESR1-mutated advanced or metastatic breast cancer.[L44918,L44948] It received a similar approval in the EU in September 2023.[L49334] Elacestrant binds to estrogen receptor-alpha (ERα) and acts as a selective estrogen receptor degrader (SERD) thanks to its ability to block the transcriptional activity of the ER and promote its degradation.[A256828,A256863,L44948] Other types of endocrine therapy, such as selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs), may lead to drug resistance over time; therefore, the use of a SERD represents a therapeutic approach for the treatment of endocrine-resistant breast cancers.[A256878] Unlike [fulvestrant], another FDA-approved SERD, elacestrant is orally bioavailable.[A256833]
Elacestrant is indicated for the treatment of postmenopausal women or adult men with ER-positive, HER2-negative, ESR1-mutated advanced or metastatic breast cancer with disease progression following at least one line of endocrine therapy.[L44918] Elacestrant is indicated for the same in the EU, with an additional requirement that patients trial a CDK 4/6 inhibitor as a prior line of therapy.[L49329]
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