In this podcast, Dr Aditya Bardia and Dr Virginia Kaklamani share their insights on the recent publication of the subgroup analyses from the phase 3 EMERALD trial by prior duration of endocrine therapy plus CDK4/6 inhibitor and in clinical subgroups. 

Key topics include 

• Identifying tumors that remain endocrine-sensitive despite acquired resistance to previous ET 

• Clinical implications of the EMERALD subgroup analyses 

• Review of elacestrant's safety profile 

Clinical takeaways 

• Duration of prior ET + CDK4/6i ≥12 months was associated with a clinically meaningful improvement in PFS for elacestrant compared with SOC endocrine monotherapy in patients with ESR1-mut, ER+/HER2– metastatic breast cancer 

• The PFS benefit associated with elacestrant was consistent across clinically relevant subgroups evaluated, including patients with bone metastases, liver and/or lung metastases, n<3 or ≥3 metastatic sites or tumors with PIK3CA-mut, TP53-mut, HER2-low tumor expression, or ESR1-mut variants D538G or Y537S/N 

• Safety analyses demonstrated that elacestrant had a manageable safety profile similar to other ETs and without evidence of the toxicities associated with other drug classes, such as CDK4/6i and PI3K/AKT/mTOR inhibitors 

• These data support current guidelines that recommend routine testing for the emergence of ESR1-mut in ctDNA at each disease progression 

This programme has been sponsored by Menarini Stemline and is intended for healthcare professionals only. 

This video was developed by https://cor2ed.com/ 

Published March 2025