Effective and Well-Tolerated Combo in ER+/HER2– Metastatic Breast Cancer

Hope S. Rugo, MD, FASCO, the Winterhof Family Endowed Professor in Breast Cancer, professor, Department of Medicine (Hematology/Oncology), director, Breast Oncology and Clinical Trials Education; medical director, Cancer Infusion Services; the University of California San Francisco Helen Diller Family Comprehensive Cancer Center, discusses how the combination of elacestrant (Orserdu) and abemaciclib (Verzenio) compares with other treatment options for patients with advanced breast cancer, whether estrogen receptor (ER)-positive or HER2-negative.

According to Rugo, this combination offers a highly effective treatment option for patients with advanced ER-positive, HER2-negative disease, providing good disease control with manageable adverse, especially when compared with other available therapies.

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0:10 | I think the question is about how this combination, elacestrant and abemaciclib, compares with other available options. For example, you could use fulvestrant, but many patients have already received fulvestrant and abemaciclib. You could try that but it has shown to not work quite as well. In cross-trial comparisons, you could go onto chemotherapy as well. I think patients can use other targeted agents, if available, but they are not widely accessible right now, especially for patients who do not have a PIK3CA mutation.

0:40 | Thinking about disease control and not just [adverse effects], this combination seems to be one of the best options. Even if you were to stay on elacestrant in this setting for a few months, you could potentially stay on it for a year and a half, especially if you have had more than a year of response to a CDK4/6 inhibitor and an aromatase inhibitor in the first-line setting. That is great, because this is an all-oral regimen. Patients might experience hair thinning, but they do not typically lose their hair. In general, the [adverse] effects are manageable, which is important for maintaining quality of life while still keeping the disease under control.