Imlunestrant

For example, elacestrant may have a little more upper GI toxicity, like some mild nausea.

Imlunestrant, a little lower to-- GI toxicity, a little diarrhea.

Um, jiradestrant and camizestrant may have some asymptomatic bradycardia.

And some of the SERDs have something called photopsia, which is, um, if a patient might notice very brief moment of flashing light in the periphery of their vision.

Um, so, you know, these ESR1 targeting agents, as you mentioned, and then we've got a bunch of them, but, you know, Orserdu, um, or, um, Elacestrant was one of them, probably one of the first.

Uh, Imlunestrant, uh, is another.

We have a recent one, Ramacestrant, which I have not yet had the chance to use, which we, we should talk about because that indication is, is sort of an interesting development.

But generally, when I have a patient who's on endocrine therapy and in metastatic breast cancer that's ER positive and their cancer progresses, that's usually the time when I'm looking to see have they developed an ESR1 mutation or perhaps even another mutation like PIC3CA-

So I think all in all, what we have seen is that the benefit of the doublet was not only seen in the CDK naive and CDK pretreated group together, but also in the sixty-five percent of the majority subgroup that was CDK pretreated.

So you're seeing patients who have first-line CDK- And then get treated with Imlunestrant plus Abema, another CDK.

You're still seeing the benefit, and that benefit is doubled in the ESR1 mutant, but also seen in ESR1 wild type.

You are seeing benefit regardless of PI3K/AKT pathway mutations as well.

Um, at least the FDA backing is for the ESR1 mutant patient population, but the NCCN endorsement is broader.

Uh, and so we certainly capitalize on this data and use it for our patients because it's so well-tolerated, and the efficacy signal is very attractive.

What questions do you still have about Imlunestrant, or what further analyses are you interested in looking at from this trial?

I mean, we obviously would love to see the final overall survival analysis for the monotherapy, right? Because we saw updated analyses, and we saw it was sustained, uh, and that was really nice.