A groundbreaking development in breast cancer treatment has emerged with the approval of elacestrant, a once-daily oral medication, by the National Institute for Health and Care Excellence (NICE) for use within the National Health Service (NHS) in England. This decision marks a significant policy reversal, as the drug was initially rejected in October due to uncertainties in the evidence. Elacestrant specifically targets advanced breast cancers that have developed mutations in the oestrogen receptor gene (ESR1), a common occurrence in up to half of advanced cases undergoing hormone therapy. These ESR1 mutations often render standard treatments ineffective, leading to disease progression. Clinical trials have demonstrated that elacestrant can delay disease progression by up to six months compared to existing therapies, offering renewed hope to over 1,100 women annually who are eligible for this treatment.
Elacestrant functions by binding to and degrading oestrogen receptors, thereby inhibiting the hormone’s ability to promote cancer cell growth and proliferation. This mechanism is particularly beneficial for patients whose cancers have become resistant to prior hormone therapies. To determine eligibility for elacestrant, patients will undergo genetic testing to identify the presence of ESR1 mutations. The availability of this targeted therapy on the NHS signifies a substantial advancement in personalized cancer care, aiming to extend survival and improve the quality of life for those affected by advanced breast cancer.
