Elacestrant
Brand names: Orserdu
Elacestrant is an oral selective oestrogen receptor degrader used to treat oestrogen-receptor-positive, HER2-negative advanced or metastatic breast cancer, including disease with an ESR1 mutation.
ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.
Clinical monograph
How it works
It binds the oestrogen receptor and promotes its degradation, blocking oestrogen-driven proliferation in hormone-receptor-positive breast cancer cells, with activity retained against some ESR1-mutant receptors.
Prescribing in practice
- ESR1 mutation status is used to select patients, and the SPC should be consulted for interactions, as exposure is affected by CYP3A4 inducers and inhibitors.
- Gastrointestinal effects such as nausea are common and may need supportive management.
- It is taken orally under specialist oncology supervision.
Monitoring
Monitor for tolerability, lipid changes and disease response, and review concomitant medicines for interactions during treatment.
Counselling the patient
- Take the tablet with food to reduce stomach upset, as advised.
- Tell your team about all other medicines and supplements, as some affect how this drug works.
Evidence & guidelines
Elacestrant is supported by trial evidence (the EMERALD trial) showing benefit in ER-positive, HER2-negative advanced breast cancer, particularly with ESR1 mutations.
Reference: NICE TA evaluation; ESMO breast cancer; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.