TPS 38 ELCIN: Elacestrant in Women and Men With CDK4/6 Inhibitor-Naive Estrogen Receptor-Positive, HER2-Negative Metastatic Breast Cancer: An Open-Label, Multicenter, Phase 2 Study

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement42nd Annual Miami Breast Cancer Conference® - Abstracts
Volume 39
Issue 4
Pages: 22-23

TPS 38 ELCIN: Elacestrant in Women and Men With CDK4/6 Inhibitor-Naive Estrogen Receptor-Positive, HER2-Negative Metastatic Breast Cancer: An Open-Label, Multicenter, Phase 2 Study

TPS 38 ELCIN: Elacestrant in Women and Men With CDK4/6 Inhibitor-Naive Estrogen Receptor-Positive, HER2-Negative Metastatic Breast Cancer: An Open-Label, Multicenter, Phase 2 Study

Background

Endocrine therapy (ET) plus a CDK4/6 inhibitor (CDK4/6i) is the mainstay treatment in first-line estrogen receptor–positive/HER2-negative (ER+/HER2–) metastatic breast cancer; however, a subset of patients is unable to tolerate CDK4/6i, and resistance to ET emerges. Intrinsic resistance mechanisms include alterations in the PI3K/AKT/mTOR or cell cycle pathways; acquired resistance mechanisms include ESR1 mutations, which emerge in up to 50% of patients during prolonged aromatase inhibitor therapy in metastatic breast cancer. In the phase 3 EMERALD trial (NCT03778931), elacestrant significantly prolonged progression-free survival (PFS) vs standard-of-care (SOC) ET and was associated with a manageable safety profile in patients with ER+/HER2– metastatic breast cancer previously treated with ET plus CDK4/6i, leading to its approval as the first clinically available oral SERD. Elacestrant significantly reduced the risk of progression or death vs SOC ET by 30% in the overall population (HR, 0.70; 95% CI, 0.55-0.88; P = .002) and by 45% in patients with ESR1 mutated tumors (HR, 0.55; 95% CI, 0.39-0.77; P = .0005). Preclinical studies demonstrated that elacestrant is equally active in both in vitro and in vivo models of ER+/HER2– breast cancer, regardless of prior exposure to CDK4/6i. Based on preclinical models and clinical efficacy data, elacestrant may improve clinical outcomes in patients who are CDK4/6i-naive and provide a convenient all-oral treatment option if combined with CDK4/6i. The phase 2 ELCIN trial (NCT05596409) will evaluate efficacy and safety of elacestrant in patients with ER+/HER2– metastatic breast cancer who received prior ET and no prior CDK4/6i in the metastatic setting.

Materials and Methods

ELCIN is an open-label, multicenter, single-arm phase 2 trial. Eligible patients are women or men with ER+/HER2− metastatic breast cancer who received 1 to 2 lines of prior ET and no prior CDK4/6i or chemotherapy in the metastatic setting. Patients must have measurable disease per RECIST v1.1 or a mainly lytic bone lesion (for bone disease only), ECOG performance status of 0 to 1, adequate bone marrow and organ function, and no active or newly diagnosed central nervous system metastases or visceral crisis. Patients will receive elacestrant at 345 mg once daily. The primary objective is investigator-assessed PFS. Secondary objectives are overall response rate, duration of response, clinical benefit rate, overall survival, patient-reported outcomes, quality of life, and safety. Exploratory objectives include elacestrant efficacy according to ESR1 mutation status, changes in biomarkers, including allele mutation frequencies (cfNAs), and the relationship between efficacy end points.

Status

ELCIN has a planned sample size of 60 patients; recruitment is ongoing worldwide.

Articles in this issue

2 Preventive Care and Screening Adherence Among Women Surviving Breast Cancer
2 Preventive Care and Screening Adherence Among Women Surviving Breast Cancer
3 Intraoperative Radiotherapy: Alive and Well in the Bronx
3 Intraoperative Radiotherapy: Alive and Well in the Bronx
4 Evaluating AI-Driven Responses in Breast Reconstruction: A Comparative Study of Response Formats
4 Evaluating AI-Driven Responses in Breast Reconstruction: A Comparative Study of Response Formats
5 Correlation Between Visual Impairment and Breast Cancer: A Cross-Sectional Study Based on the National Health Interview Surveys
5 Correlation Between Visual Impairment and Breast Cancer: A Cross-Sectional Study Based on the National Health Interview Surveys
6 Peer Support Programming Among Women At-Risk for Surviving Breast Cancer: Facilitators and Barriers to Community-Based Patient Navigation and the Role of Quality of Life
6 Peer Support Programming Among Women At-Risk for Surviving Breast Cancer: Facilitators and Barriers to Community-Based Patient Navigation and the Role of Quality of Life
7 Metaplastic Breast Cancer: A Retrospective Chart Review of Clinical Features
7 Metaplastic Breast Cancer: A Retrospective Chart Review of Clinical Features
8 A Case Series Exploring Characteristics and Outcomes of Metachronous Primary Breast and Lung Cancer in a Diverse Cohort
8 A Case Series Exploring Characteristics and Outcomes of Metachronous Primary Breast and Lung Cancer in a Diverse Cohort
9 Body Mass Index, Cancer Risk Behaviors, and Readiness for Dietary Change Among Women Surviving With Breast Cancer
9 Body Mass Index, Cancer Risk Behaviors, and Readiness for Dietary Change Among Women Surviving With Breast Cancer
10 AI as a Bridge: Can ChatGPT Help Patients Understand Their Breast Radiology Reports?
10 AI as a Bridge: Can ChatGPT Help Patients Understand Their Breast Radiology Reports?
12 Gut Microbiome Composition and Pathological Complete Response After Chemotherapy in Breast Cancer: Insights From a Pilot Study
12 Gut Microbiome Composition and Pathological Complete Response After Chemotherapy in Breast Cancer: Insights From a Pilot Study
13 Preliminary Analysis of Change During Treatment of Financial Toxicity and Quality of Life in Breast Cancer Patients
13 Preliminary Analysis of Change During Treatment of Financial Toxicity and Quality of Life in Breast Cancer Patients
15 Utilizing Circulating Tumor Cells to Guide HER2-Directed Therapy in IHC/FISH-Negative HER2+ Metastatic Breast Cancer
15 Utilizing Circulating Tumor Cells to Guide HER2-Directed Therapy in IHC/FISH-Negative HER2+ Metastatic Breast Cancer
16 A Miami Hospital’s Infrastructure to Help Decrease Late-Stage Breast Cancer Diagnosis and Improve Health Equity
16 A Miami Hospital’s Infrastructure to Help Decrease Late-Stage Breast Cancer Diagnosis and Improve Health Equity
17 Salmonella and the Breast: A Literature Review of Salmonella-Induced Breast Abscesses
17 Salmonella and the Breast: A Literature Review of Salmonella-Induced Breast Abscesses
18 Tolerability of First-Line Treatment With Ribociclib for Metastatic Breast Cancer Using 2 Large US Data Sources
18 Tolerability of First-Line Treatment With Ribociclib for Metastatic Breast Cancer Using 2 Large US Data Sources
Recent Videos
Leading experts in the breast cancer field highlight the use of CDK4/6 inhibitors, antibody-drug conjugates, and other treatment modalities.
Patients with node-negative disease who are older and have comorbidities may not be suitable to receive CDK4/6 inhibitors.
An observed carryover effect with CDK4/6 inhibitors may reduce the risk of recurrence years after a patient stops treatment.
Breast oncologist Jade E. Jones, MD, says she tries to send patients with BRCA-mutant HR-positive TNBC to clinical trials that use PARP inhibitors.