OBJECTIVES: Additional treatment options are needed for patients with HR+/HER2- aBC. Selective estrogen receptor degraders (SERDs) have emerged as a promising treatment strategy for patients with ESR1-mutant aBC. The current standard of care (SOC) consists of fulvestrant, administered via intramuscular injection, for estrogen receptor (ER)-positive aBC. Elacestrant is a novel oral SERD under review for FDA approval. Results from the EMERALD phase III trial have demonstrated an improved 12-month progression-free survival (PFS) rate among patients with ER-positive aBC treated with elacestrant when compared to those who received the SOC (22.32% vs. 9.42%). This survey-based study aimed to evaluate patterns of genetic testing, prescribing behavior, and perceptions of treatment options for HR+ /HER2- aBC among community oncologists.

METHODS: Survey questions were administered to U.S. community oncologists at an in-person forum in April 2022. Descriptive statistics were used to analyze the results.

RESULTS: Respondents (N=53) reported their primary specialty as medical oncology (64%) and hematology oncology (36%) and had an average of 19 years in practice. Most respondents (73%) reported that they order next-generation sequencing testing at the time of metastasis/relapse, however few indicated testing for ESR1 status at initial diagnosis. 64% of respondents indicated they were “very likely to prescribe elacestrant”. Important factors when considering treatment for HR+/HER2- aBC with a novel therapy compared to SOC were: improved PFS rates (26%), ESR1 mutation status (25%), and improved overall survival (25%).

CONCLUSIONS: Findings demonstrate that community oncologists perceive there to be an opportunity for improvement over existing SOC for HR+/HER2- aBC. Elacestrant is an investigational oral SERD that is viewed favorably by providers and associated with improved PFS based on clinical trial data.