Elacetrant is an oral selective estrogen receptor degrading agent (SERD) for the treatment of advanced or metastatic breast cancer patients with ER positive, HER2 negative and ESR1 mutation. It is suitable for postmenopausal women and adult men, and needs to be used after at least one endocrine therapy fails. Its target is estrogen receptor alpha (ER alpha), which is currently not on the market in China. Attention should be paid to adjusting the dosage of medication and handling missed doses.

1 Indications and targets

Elastigmine is applicable to postmenopausal women or adult men with ER positive, HER2 negative, ESR1 mutated advanced or metastatic breast cancer, and at least one endocrine therapy is required for disease progression. Its target is estrogen receptor alpha (ER alpha), which inhibits tumor growth by degrading the receptor.

2 Medication information

(1) Usage and dosage

The recommended dosage is 258mg orally once daily (three tablets of 86mg each). If a reduction is needed, it can be adjusted to 172mg (two tablets of 86mg each). Adjust the dose according to the level of adverse reactions, maintain the original dose for level 1, interrupt or reduce the dose for levels 2-4, and permanently discontinue treatment for severe toxicity.

(2) Omission and Overtreatment

If the missed dose exceeds 6 hours or vomiting occurs, skip the dose and take the medication normally the next day. Drug overdose requires immediate medical attention. Not taking medication on time does not require supplementation, avoid double dosage.

3 Precautions for Special Groups

(1) Elderly patients

Patients over 65 years old do not need to adjust the dosage, but data for the population over 75 years old is limited and should be used with caution.

(2) Renal dysfunction

Mild to moderate renal impairment does not require dose adjustment, and there is insufficient data on patients with severe renal impairment. It is recommended to use with caution.

(3) Child patients

The safety and efficacy of patients under 18 years old have not been established and their use is prohibited.