Oral Elacestrant Requires Patient Education in Metastatic ER+ Breast Cancer

Nausea and upper GI discomfort are frequently linked with use of the oral SERD.

Elacestrant (RAD1901) is an oral agent, meaning there is no need for intramuscular shots, compared with other selective endocrine receptor degraders (SERDS), such as fulvestrant (Faslodex), for use in select patients with advanced breast cancer, explains Aditya Bardia, MD, MPH.

Bardia, who is director of breast cancer research and medical oncology, and attending physician at Massachusetts General Hospital Cancer Center, as well as associate professor at Harvard Medical School, recently presented on elacestrant’s performance in the phase 3 EMERALD trial (NCT03778931) during the 2021 San Antonio Breast Cancer Symposium (SABCS).

The data revealed that elacestrant improved progression-free survival among patients with estrogen receptor–positive, HER2-negative metastatic breast cancer who previously received CDK4/6 inhibition.1

In an interview with Oncology Nursing News®, Bardia highlighted key pieces of patient education in regard to the agent and its optimal use.

“Because it is an oral agent, I think the thing to consider is that it does cause nausea,” he said. “It can also cause upper GI discomfort. Those are important education pieces for patients.”

“If a patient is having a lot of acid-like symptoms, then the use of a proton pump inhibitor or other anti-acid medications would be very reasonable,” he added. “If a patient really has severe nausea, then the use of anti-nausea medication would be reasonable. But, overall, the drug is well tolerated.”

References

  1. Bardia A. Elacestrant, an oral selective estrogen receptor degrader (SERD), vs investigator’s choice of endocrine monotherapy for ER+/HER2-advanced/metastatic breast cancer (mBC) following progression on prior endocrine and CDK4/6 inhibitor therapy: Results of EMERALD phase 3 trial. Presented at: 2021 San Antonio Breast Cancer Symposium; December 7-10, 2021; San Antonio, TX. Abstract GS2-02.