The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Elacestrant for ESR1 Mutant ER-Positive Breast Cancer: Oral Selective Estrogen Receptor Degrader

Novel oral SERD targeting estrogen receptor degradation in endocrine therapy-resistant ESR1 mutated metastatic breast cancer

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Elacestrant for ESR1 Mutant ER-Positive Breast Cancer: Oral Selective Estrogen Receptor Degrader?

Elacestrant is oral selective estrogen receptor degrader binding to ER and inducing receptor conformational change leading to degradation.

ESR1 mutations occur in approximately 30-40% of metastatic ER-positive breast cancer progressing on aromatase inhibitors.

Most common ESR1 mutations include Y537S and D538G producing constitutive receptor activation independent of estrogen.

FDA approval is for ESR1-mutated, ER-positive, HER2-negative advanced or metastatic breast cancer after prior endocrine therapy.

Liquid biopsy with circulating tumor DNA testing identifies ESR1 mutations enabling treatment selection without invasive biopsy.

Symptoms

Nausea is most common adverse effect requiring antiemetic prophylaxis with timing of dose administration.
Fatigue, vomiting and decreased appetite affect quality of life requiring supportive care and symptom management.
Vasomotor symptoms including hot flashes reflect estrogen receptor degradation and effective therapy mechanism.
Constipation, abdominal pain and dyspepsia are common gastrointestinal side effects.
Increased liver function tests, dyslipidemia and bone-related effects require monitoring.

Risk Factors

ESR1 mutations as resistance mechanism develop after aromatase inhibitor therapy with monitoring through liquid biopsy.
Concurrent strong CYP3A4 inhibitors require dose adjustments given metabolic interactions.
Hepatic impairment requires dose modification per established criteria.
Pre-existing nausea, gastroesophageal reflux disease may worsen with elacestrant therapy.
Bone health considerations including baseline DEXA and ongoing surveillance recommended.

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • ER-positive HER2-negative metastatic breast cancer progression on prior endocrine therapy warrants ESR1 mutation testing.
  • Liquid biopsy ESR1 testing through circulating tumor DNA provides convenient identification of actionable mutation.
  • Severe nausea, vomiting, dehydration or weight loss require evaluation and supportive care optimization.
  • Significant transaminase elevation, jaundice or signs of hepatotoxicity require oncology evaluation.
  • Multidisciplinary care including medical oncology, breast surgery and palliative care optimizes outcomes.

Treatment Methods

01
Elacestrant 345 mg orally daily continuous dosing represents standard regimen taken with food.
02
Antiemetic prophylaxis with serotonin antagonists or olanzapine before dosing reduces nausea.
03
Liquid biopsy ESR1 testing at progression on prior endocrine therapy identifies treatment candidates.
04
Bone health management with calcium, vitamin D supplementation, baseline DEXA and bisphosphonate when indicated.
05
Comprehensive supportive care including symptom management, nutrition support, drug interaction review and patient education supports successful long-term therapy as biomarker-driven approach for ESR1-mutated metastatic breast cancer.

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Onkoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Anaemia

Dahiliye (İç Hastalıkları)

Anaemia is a low haemoglobin level that reduces oxygen delivery, causing fatigue, pallor, and shortness of breath. It is not a disease itself but a sign of many underlying conditions. Most cases are correctable with appropriate diagnosis and treatment.

Iron Deficiency Anaemia

Dahiliye (İç Hastalıkları)

Iron deficiency anaemia develops when dietary intake, absorption, or losses create an iron shortfall, most often affecting women and children. Identifying the underlying cause is the core of management, alongside iron replacement.

Vitamin B12 Deficiency

Dahiliye (İç Hastalıkları)

Vitamin B12 deficiency can cause megaloblastic anaemia, neurological symptoms, and cognitive impairment. Early treatment with intramuscular or oral B12 largely prevents irreversible complications.

Hypertension (High Blood Pressure) Management

Dahiliye (İç Hastalıkları)

Hypertension is often called the silent killer because it progresses symptom-free for years and can damage the heart, brain, kidneys, and eyes. Regular monitoring, lifestyle change, and evidence-based drug therapy dramatically reduce cardiovascular risk.

Chronic Kidney Disease

Dahiliye (İç Hastalıkları)

Chronic kidney disease is one of the most common complications of chronic conditions such as diabetes and hypertension, and can be silent in its early stages.

Hepatitis B (HBV)

Dahiliye (İç Hastalıkları)

Hepatitis B is a DNA virus infection causing acute and chronic hepatitis with risk of cirrhosis and hepatocellular carcinoma; diagnosis integrates HBsAg, HBeAg, anti-HBc, and HBV DNA with management based on disease phase using nucleos(t)ide analogues (entecavir, tenofovir) and universal infant vaccination.

Hepatitis C (HCV)

Dahiliye (İç Hastalıkları)

Hepatitis C is an RNA virus causing chronic hepatitis that may progress to cirrhosis and hepatocellular carcinoma; modern direct-acting antiviral (DAA) pangenotypic regimens (sofosbuvir/velpatasvir, glecaprevir/pibrentasvir) achieve sustained virologic response over 95% in 8–12 weeks with universal adult screening and cure for nearly all patients.

Fatty Liver Disease

Dahiliye (İç Hastalıkları)

Non-alcoholic fatty liver disease (NAFLD) is closely related to obesity and metabolic syndrome and is largely reversible with early treatment.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.