Retrospective Analysis of Real-World Elacestrant Use in Two Large Austrian Cancer Centers.
6 affiliations
- 1Division of Oncology, Department of Medicine I, Medical University Vienna, Vienna, Austria.
- 21st Department of Medicine, Center for Oncology and Hematology, Klinik Ottakring, Austria.
- 3Division of Visceral Surgery, Department of General Surgery, Medical University Vienna, Vienna, Austria.
- 4Department of Gynecology and Gynecological Oncology, Medical University of Vienna, Vienna, Austria.
- 5Institute for Pathology, Medical University Vienna, Vienna, Austria.
- 6Department of Radiation Oncology, Medical University Vienna, Vienna, Austria.
Abstract
Introduction
Elacestrant is an oral selective estrogen receptor degrader (SERD) approved for the treatment of hormone receptor-positive (HR-positive), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) following progression on endocrine therapy and CDK4/6 inhibitors. While randomized trial data from the EMERALD study demonstrated its clinical benefit, real-world evidence remains limited.Methods
We conducted a retrospective chart review of patients with HR-positive/HER2-negative MBC treated with elacestrant at two large cancer centers in Vienna, Austria. Clinical outcomes and safety were evaluated in routine clinical practice by experienced oncologists.Results
Elacestrant demonstrated clinically meaningful efficacy in a heavily pretreated patient population of 30 patients with estrogen receptor 1 (ESR1) mutations. Median age was 65 years and the cohort was predominantly postmenopausal (86.7%). Before initiation of elacestrant, patients had received a median of two lines of endocrine therapy and one line of chemotherapy. Co-mutations of ESR1/PIK3CA were present in 33.3% of patients. Median progression-free survival (PFS) was 3.6 months (95% CI 2.96-4.24) and median overall survival was 20.2 months (95% CI 5.04-35.36). In univariate analyses, de novo metastatic disease and the presence of a single ESR1-mutated exon were associated with longer PFS, whereas the ESR1 E380Q mutation was associated with shorter PFS. Adverse events of any grade occured in 46.7% of patients. Within our cohort, a low rate of dose reductions (3.3%) was found. Subsequent therapies after elacestrant mainly consisted of antibody-drug conjugates (36.7% of patients) and chemotherapy (26.7%).Conclusion
In this real-world cohort, elacestrant showed effectiveness and tolerability similar to data observed in the EMERALD trial. Larger prospective real-world analyses are warranted to further validate these findings and define optimal patient selection.
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BibTeX
@article{vesenmayer2026retrospective,
title = {{Retrospective Analysis of Real-World Elacestrant Use in Two Large Austrian Cancer Centers.}},
author = {Lisa Vesenmayer and Simon Udovica and Kerstin Wimmer and Constantin Mannsbart and Katharina Kantner and Ruth Exner and Zsuzsanna Bago-Horvath and Stefan Konrad and Kathrin Strasser-Weippl and Christian F Singer and Leonhard Müllauer and Rupert Bartsch and Maximilian Marhold},
journal = {Breast care (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.1159/brc/abrag003},
url = {https://europepmc.org/article/MED/42927396},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Retrospective Analysis of Real-World Elacestrant Use in Two Large Austrian Cancer Centers.
AU - Lisa Vesenmayer
AU - Simon Udovica
AU - Kerstin Wimmer
AU - Constantin Mannsbart
AU - Katharina Kantner
AU - Ruth Exner
AU - Zsuzsanna Bago-Horvath
AU - Stefan Konrad
AU - Kathrin Strasser-Weippl
AU - Christian F Singer
AU - Leonhard Müllauer
AU - Rupert Bartsch
AU - Maximilian Marhold
PY - 2026
DA - 2026/10/19
JO - Breast care (Basel, Switzerland)
DO - 10.1159/brc/abrag003
UR - https://europepmc.org/article/MED/42927396
AB - Introduction Elacestrant is an oral selective estrogen receptor degrader (SERD) approved for the treatment of hormone receptor-positive (HR-positive), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) following progression on endocrine therapy and CDK4/6 inhibitors. While randomized trial data from the EMERALD study demonstrated its clinical benefit, real-world evidence remains limited.Methods We conducted a retrospective chart review of patients with HR-positive/HER2-negative MBC treated with elacestrant at two large cancer centers in Vienna, Austria. Clinical outcomes and safety were evaluated in routine clinical practice by experienced oncologists.Results Elacestrant demonstrated clinically meaningful efficacy in a heavily pretreated patient population of 30 patients with estrogen receptor 1 (ESR1) mutations. Median age was 65 years and the cohort was predominantly postmenopausal (86.7%). Before initiation of elacestrant, patients had received a median of two lines of endocrine therapy and one line of chemotherapy. Co-mutations of ESR1/PIK3CA were present in 33.3% of patients. Median progression-free survival (PFS) was 3.6 months (95% CI 2.96-4.24) and median overall survival was 20.2 months (95% CI 5.04-35.36). In univariate analyses, de novo metastatic disease and the presence of a single ESR1-mutated exon were associated with longer PFS, whereas the ESR1 E380Q mutation was associated with shorter PFS. Adverse events of any grade occured in 46.7% of patients. Within our cohort, a low rate of dose reductions (3.3%) was found. Subsequent therapies after elacestrant mainly consisted of antibody-drug conjugates (36.7% of patients) and chemotherapy (26.7%).Conclusion In this real-world cohort, elacestrant showed effectiveness and tolerability similar to data observed in the EMERALD trial. Larger prospective real-world analyses are warranted to further validate these findings and define optimal patient selection.
SN - 1661-3791
SN - 1661-3805
ER -