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Relacorilant plus nab-paclitaxel improved PFS and showed a trend toward longer OS in platinum-resistant ovarian cancer in ROSELLA.

Relacorilant Combo Boosts PFS in Resistant Ovarian Cancer

Lasting survival benefits vs chemotherapy or monotherapy were achieved with nivolumab and ipilimumab for patients MSI-H/ dMMR metastatic colorectal cancer.

Nivolumab/Ipilimumab To Be New MSI-H/dMMR mCRC Standard of Care

T-DXd led to an ORR of 59.4% vs 33.9% with chemo, regardless of biomarker status, in HR+, HER2-low metastatic breast cancer, per DESTINY-Breast06.

T-DXd PFS Benefit Significant Across HR+, HER2-Low Breast Cancer Mutations

A machine learning model applied to CheckMate 9ER may help predict outcomes and resistance in advanced renal cell carcinoma.

AI Tool May Predict Response, Resistance in Advanced RCC

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Dr. Jackson is a certified oncology and bone marrow transplant clinical nurse specialist with clinical expertise in hematology/stem cell transplantation/cellular therapy. She is currently unit director–providing oversight of the clinical and fiscal operations of an inpatient hematology unit. Dr. Jackson is also a member of the National Association of Clinical Nurse Specialist, American Asociation of California Nurse Leaders, and the Oncology Nurses Society.

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Oncology nurses are paramount to the success of patients, especially through their work on clinical trials.

The Evolving Role of the Oncology Nurse in Clinical Trials

Gina Mauro currently serves as Vice President of Content at MJH Life Sciences, overseeing 

®. Gina joined the company in 2015 and has held various positions on 

Prior to joining MJH Life Sciences, she worked at Gannett as a full-time reporter with the Asbury Park Press. Email: gmauro@onclive.com

Kristi Rosa joined MJH Life Sciences in 2016 and has since held several positions within the company. Prior to working at the company, she served as lead copywriter and marketing coordinator at The Strand Theater. Email: krosa@onclive.com

Randi Kihnel, MSN, APRN, ACCNS-AG is an advanced practice nurse who works in GI Medical Oncology at Ochsner MD Anderson Cancer Center.

Advanced practice providers have the opportunity to instill hope in patients through education and personalized care.

Case Study: Bridging the Gap for Patients With Metastatic CRC

The FDA approved a perioperative pembrolizumab regimen in head and neck squamous cell carcinoma, marking the first approval in this cancer type in 6 years.

FDA Approves Perioperative Pembrolizumab in Head and Neck SCC

Oncology Nursing News connects oncology nurses and APPs with updates on therapy advances, side effect management, and patient-centered cancer care.

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Oncology Nursing News – Clinical Insights for Cancer Care Nurses

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The combination of trastuzumab deruxtecan with pertuzumab shows promise as a standard of care for HER2-positive advanced breast cancer.

First-Line T-DXd/Pertuzumab Yields Improved PFS in HER2+ mBC

Selecting the right treatment path for a patient with an ESR1 mutation in metastatic breast cancer can help build trust.

Q&A: Strong Treatment Choices Can Build Trust in Patients With ESR1+ mBC

The amount of CDK4/6-targeting treatment options available for patients with HR-positive breast cancer allows providers to personalize treatment.

How CDK4/6 Inhibitors Enable More Personalized Treatment in HR+ mBC

Early trial data show 13.3% objective response with avutometinib, abemaciclib, and fulvestrant in HR+/HER2– breast cancer resistant to CDK4/6 inhibitors.

Avutometinib Triplet Active in Resistant HR+/HER2– Breast Cancer

T-DXd Plus Pertuzumab Improves PFS Over THP in HER2+ Metastatic Breast Cancer

Panelists discuss how a multidisciplinary team approach to patient education and medication management is crucial for ensuring adherence and optimal outcomes with oral medications like elacestrant.

Patient Education, Shared Decision-Making, and Optimizing Care for ESR1-Mutated Breast Cancer

Video content above is prompted by the following: 

Clinical Brief: Implementation and Patient Support Strategies

Role of multidisciplinary care team in patient education and support

Importance of early intervention for side effect management

Strategies for ensuring medication adherence with oral therapy

Value of nurse coordinators and pharmacist integration

Flexible approaches, including chemotherapy-endocrine therapy sequencing

Team-based approach crucial for successful oral therapy management

Early touchpoints in first month prevent long-term discontinuation

Patient education impacts adherence and anxiety management

Consider short-course chemotherapy followed by endocrine therapy in select cases

Communication protocols essential for optimal outcomes

The discussion highlighted that successful implementation of oral targeted therapies requires comprehensive support systems and proactive communication strategies to ensure optimal patient outcomes and treatment adherence.

Panelists discuss how real-world studies have shown improved outcomes with elacestrant compared with the original EMERALD trial data, demonstrating that proper patient selection leads to better treatment responses.

Real-World Experience: The Efficacy and Tolerability of Oral Elacestrant for Patients with ESR1 Mutations

Clinical Brief: Real-World Evidence Supporting Elacestrant Use

Real-world outcomes exceeding clinical trial results (unusual finding)

GUARDIAN database analysis: 6.4 months median time to treatment failure

Komoda database: 6.8 months progression-free survival (9.4 months if fulvestrant-naive)

Expert clinical experience aligning with real-world data

Importance of appropriate patient selection for optimal outcomes

Real-world PFS (6.4-6.8 months) exceeds EMERALD trial results (3.8 months)

Fulvestrant-naive patients show particularly strong outcomes (9.4 months)

Early adopters report better results with refined patient selection

Confirms benefit of using elacestrant in second-line for appropriate patients

Real-world data validates subgroup findings from EMERALD

The real-world evidence conclusively demonstrates that proper patient selection based on EMERALD subgroup analyses results in significantly improved clinical outcomes compared with the overall trial population.

Panelists discuss balancing clinical trial data with real-world patient factors when choosing between treatment options, emphasizing the importance of quality of life alongside cancer control in the second-line setting.

Managing Elacestrant Treatment: From Patient Selection to Supportive Care

Clinical Brief: Second-Line Treatment Decision Framework

Integration of patient factors in treatment selection

Balance between efficacy and quality-of-life considerations

Practical considerations: insurance, copays, administration route

Sequential versus concurrent treatment strategies

Role of shared decision-making in complex treatment landscape

Treatment selection requires balance of clinical trial data with patient-specific factors

Consider timing of treatments (when versus if to use each therapy)

Patient preferences regarding administration route can influence decisions

Functional status and treatment urgency guide sequencing strategy

Financial and logistical factors play significant role in real-world decisions

The experts emphasized that second-line therapy decisions require integrating scientific evidence with individualized patient assessment, considering medical and practical factors.

Panelists discuss how the EMERALD trial demonstrated elacestrant's efficacy in ESR1-mutated tumors, particularly in patients who had received CDK4/6 inhibitors for at least 12 months. This led to its FDA approval for this specific population.

EMERALD Trial Results: What Prior CDK4/6i Duration Means for Treatment Success

Clinical Brief: Elacestrant Subgroup Benefits and Safety Profile

Efficacy across different disease sites (bone-only versus visceral)

Impact of tumor burden (multiple sites of metastasis)

Co-mutation status (PIK3CA, p53) and treatment efficacy

Safety profile focusing on gastrointestinal (GI) tolerability and lipid monitoring

FDA recommendation for lipid profile monitoring requirements

Elacestrant efficacy maintained in visceral disease and high tumor burden

Unexpected positive results even in p53-mutant tumors

Less antiemetic use required compared with aromatase inhibitors

New requirement: lipid profile before treatment and as needed thereafter

Overall well-tolerated side effect profile with manageable GI symptoms

The comprehensive subset analyses support broad applicability of elacestrant in ESR1-mutant patients who demonstrate endocrine sensitivity, regardless of traditional adverse prognostic factors.

Panelists discuss how to communicate genomic testing results to patients and make shared treatment decisions, particularly when multiple targeted therapy options are available for patients with ESR1 and PIK3CA mutations.

Exploring a Patient Case: Biomarker Testing After Progression and Discussing Treatment Choices With Your Care Team

Clinical Brief: EMERALD Trial Insights for ESR1-Mutant Breast Cancer

Overview of EMERALD trial design and patient population

Co-primary end points and efficacy outcomes for ESR1-mutant tumors

Critical subset analyses identifying best responders (>12 months prior CDK4/6)

Median PFS outcomes: 8.6 months versus 3.8 months in optimal patients

Limited relevance of variant allele frequency (VAF) for treatment selection

Elacestrant approved specifically for ESR1-mutant metastatic breast cancer

Prior CDK4/6 duration greater than 12 months predicts better response (8.6 versus 1.9 months PFS)

Benefit maintained across visceral disease, multiple metastatic sites

PIK3CA co-mutations do not negate elacestrant benefit

VAF is not currently useful for treatment selection decision-making

The EMERALD trial established that patient selection based on endocrine sensitivity duration, rather than just mutation presence, optimizes treatment outcomes with elacestrant.

Panelists discuss how to approach second-line therapy decisions for patients with metastatic breast cancer, emphasizing the importance of biomarker testing, including ESR1 mutations, and considering patient-specific factors.

Navigating Treatment After Progression: Testing, ESR1 Mutations and Tolerable Options

Clinical Brief: Biomarker Testing Strategy in Second-Line Therapy

Strategic approach to biomarker testing when transitioning to second-line therapy

Importance of liquid biopsy versus tissue biopsy for ESR1 mutation detection

Role of PIK3CA and other pathway mutations in treatment selection

Shared decision-making process for selecting between multiple treatment options

Clinical assessment of endocrine sensitivity duration as a treatment predictor

Liquid biopsy preferred for ESR1 mutation detection due to subclonal nature (15%-20% better detection)

PIK3CA mutations are clonal and detectable in the initial tissue biopsy

Prior CDK4/6 inhibitor response duration greater than 12 months indicates endocrine sensitivity

Multiple treatment options require individualized patient assessment

Quality-of-life considerations balance with efficacy outcomes

Metastatic Breast Cancer

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