ArticleClinical cancer research : an official journal of the American Association for Cancer Research2026
Real-World Outcomes of Elacestrant in ER+, HER2-, ESR1-Mutant Metastatic Breast Cancer.
Article in Clinical cancer research : an official journal of the American Association for Cancer Research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Dynamic circulating tumor DNA profiling of ESR1 mutations in HR+/HER2- advanced breast cancer: from prognostic biomarker to clinical decision-making - a comprehensive review.Frontiers in oncology · 2026Pooled it
- Article
- Navigating first- and second-line treatment options in hormone receptor-positive HER2-negative advanced breast cancer.The oncologist · 2026Review
- Article
- Article
- Post-CDK4/6 Inhibitor Therapeutic Approaches in Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer: Current Evidence and Emerging Strategies-A Narrative Review.Diagnostics (Basel, Switzerland) · 2026Review
- Cutting-edge advances in endocrine therapy for breast cancer (Review).Oncology letters · 2026Review
- Review
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe EMERALD trial led to the approval of elacestrant for estrogen receptor (ER)-positive, HER2-negative, estrogen receptor 1 (ESR1)-mutated advanced or metastatic breast cancer (mBC) with disease progression following at least one line of endocrine therapy (ET). Subgroup analyses provided evidence suggesting that elacestrant enables ET sequencing in the second line before other targeted combinations, which could delay chemotherapy-based regimens. EXPERIMENTAL
designThis study used claims data from the Komodo Research Dataset linked with Foundation Medicine Inc. clinical genomic data from patients with estrogen receptor+/HER2- mBC harboring an ESR1 mutation treated with elacestrant. The primary outcome measure was time to next treatment (TTNT).
resultsAmong 306 patients, 93.8% had prior ET ± cyclin-dependent kinase 4/6 inhibitor for ≥12 months, 50.0% had prior chemotherapy, and 72.2% had prior fulvestrant. Median TTNT (mTTNT) was 8.2 months [95% confidence interval (CI), 6.3-13.0] in patients with 1 to 2 prior lines and 7.5 months (95% CI, 7.1-9.9) in those with ≥3 prior lines of ET. In patients with coexisting ESR1- and PI3K-pathway-mutated tumors, mTTNT was 6.3 months (95% CI, 4.8-7.9). mTTNT was 7.9 months (95% CI, 7.1-9.8) in all patients and was also sustained in patients with no prior fulvestrant [12.9 months (95% CI, 7.2-not reached)], no prior chemotherapy [8.4 months (95% CI, 7.1-13.3)], visceral metastasis [7.9 months (95% CI, 7.0-9.9)], and liver metastases [7.2 months (95% CI, 6.3-9.0)].
conclusionsElacestrant demonstrated a durable benefit in real-world clinical practice, particularly in earlier lines and in patients with prolonged prior ET exposure. Despite coexisting ESR1 and PI3K pathway mutations, TTNT remained clinically meaningful, reinforcing the role of elacestrant in personalized ET sequencing strategies prior to chemotherapy, antibody-drug conjugates, or targeted combinations. See related article by Lloyd et al., p. 169.
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