Oral selective oestrogen receptor degrader (SERD, specialist)
Elacestrant
Brand names: Orserdu
Adult dose
Dose: 345mg PO OD with food
Route: Oral
Frequency: OD
Clinical pearls
- ESR1-mutated, ER+/HER2-, advanced or metastatic breast cancer after ≥1 line of endocrine therapy including CDK4/6 inhibitor
- NICE TA evaluation; ESMO breast cancer guidelines
- Specialist oncology — tumour ESR1 mutation testing required
Contraindications
- Pregnancy
- Severe hepatic impairment
- Hypersensitivity
Side effects
- Nausea
- Vomiting
- Diarrhoea
- Fatigue
- Hot flushes
- Hyperlipidaemia
- ALT/AST elevation
- Bone pain
Interactions
- Strong CYP3A4 inhibitors/inducers
Monitoring
- LFTs
- Lipids
- Disease response (RECIST)
Reference: BNF; NICE TA evaluation; ESMO breast cancer; SmPC; https://bnf.nice.org.uk/drugs/elacestrant/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators