Virginia Kaklamani, MD, UT Southwestern Medical Center, Dallas, TX, discusses how the updated results of the Phase III EMERALD (NCT03778931) trial, which investigated elacestrant versus standard of care endocrine therapy in patients with ER+/HER2- metastatic breast cancer, by duration of prior CDK4/6i in the metastatic setting. The duration of prior CDK4/6i in the metastatic setting was positively associated with progression-free survival (PFS), the longer the duration of prior CDK4/6i in the metastatic setting, the longer the PFS on elacestrant versus standard of care. These results suggest clinicians will have a responsibility to decipher whether a patients tumor is endocrine-sensitive or endocrine-resistant. If a tumor is endocrine-resistant, then the next step will be chemotherapy. For the majority of tumors that are endocrine sensitive, using single-agent endocrine therapy, such as elacestrant, will be a viable option. This interview took place at the San Antonio Breast Cancer Symposium (SABCS) 2022 in San Antonio, TX.

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