Emerging Endocrine Therapies in Breast Cancer Treatment

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EP: 1.Emerging Endocrine Therapies in Breast Cancer Treatment

Erika Hamilton, MD, director of Breast Cancer Research at the Sarah Cannon Research Institute, discusses some of the emerging and most promising endocrine therapies in breast cancer.

The first oral selective estrogen receptor degrader (SERD) to be approved by the FDA was elacestrant (Orserdu). Hamilton highlights camizestrant, another SERD that has demonstrated better efficacy than treatment with fulvestrant and shares that the agent may soon be available for broader use.

There are also proteolysis-targeting chimeras (PROTACs) in development, including vepdegestrant (ARV-471), which is currently being tested in combination with CDK4/6 inhibitors.

Transcription:

0:09 | Certainly we have 1 FDA-approved oral SERD, elacestrant, that is restricted currently to patients with ESR1 mutations, but there are a lot more coming. The other one to have randomized data was camizestrant. It essentially looked at 2 different doses of camizestrant, but it easily beat fulvestrant. I think we know we are going to see data in multiple settings with that drug coming. So, certainly oral SERDS.

0:40 | One of the other classes that is getting talked about quite a lot are the PROTACs or proteolysis targeting chimeras. It is a different way to degrade estrogen through proteasome, and you kind of ubiquitination of the target the estrogen receptor. The one farthest along is ARV-471, and we have seen data from the phase 1 trial, as well as in combination with palbociclib [Ibrance], and that is also currently enrolling in registrational trials.

1:12 | There are other newer agents coming, and then I like to call it the word salad of endocrine therapy. But we have CERANs, complete estrogen receptor antagonists, we have SERMs, newer selective estrogen receptor modulators, we have SERCAs, selective estrogen receptor covalent antagonists, so a lot of different drugs coming to essentially work for patients.