An evaluation of fulvestrant for the treatment of metastatic breast cancer

Mohsin Soleja, Ganesh V. Raj, Nisha Unni

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Introduction: Fulvestrant is currently the only selective estrogen receptor degrader (SERD) that is approved for clinical use in estrogen receptor (ER) positive advanced breast cancer (ABC). The drug is approved as single-agent therapy in the first and second-line setting of metastatic ER-positive breast cancer. Areas covered: In this review, the authors review the preclinical studies that were pivotal in the development of fulvestrant, the pharmacologic properties of the drug, and the key clinical trials that resulted in its approval for clinical use. The authors discuss mechanisms of endocrine resistance and potential targets for endocrine refractory disease while highlighting ongoing studies that assess fulvestrant use with novel agents. Expert opinion: While fulvestrant has limited use in the first-line setting in advanced breast cancer, it is most frequently used in the second line after progression with aromatase inhibitors. The combination of fulvestrant with CDK4/6 inhibitors has shown a clear benefit over monotherapy in patients who progress on prior endocrine therapy. Further study is necessary to assess if patient outcomes can be enhanced by optimizing the sequence of endocrine therapies, targeting resistance pathways with novel agents, and development of new agents in the SERD class.

Original languageEnglish (US)
Pages (from-to)1819-1829
Number of pages11
JournalExpert Opinion on Pharmacotherapy
Issue number15
StatePublished - Oct 13 2019


  • Fulvestrant
  • Selective Estrogen Receptor Positive (SERD)
  • advanced breast cancer
  • endocrine resistance
  • hormone-receptor positive
  • metastatic breast cancer

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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