Hormonal Receptor (HR)-Positive HER2 Negative Breast Cancer Patients Treated With Preoperative ELacestrant and PULSAR Adaptive Radiotherapy: a Phase II Study (HELP Trial)

This is a proof-of-concept phase II trial to assess the safety (as primary endpoint) and clinical efficacy of neoadjuvant therapy with Elacestrant and PULSAR.
The study will enroll 21 postmenopausal patients with early HR+ HER2- node positive BC, clinically staged II-III. Patients will receive Elacestrant 345 mg orally once daily for 24 weeks and PULSAR on the MRI-based breast gross tumor volume (GTVt), consisting of 10 Gy "pulse" every 4 weeks for a maximum of 5 or less in case of radiologic complete response.
Surgery will be planned 24 weeks after Elacestrant initiation and at least 2 weeks from the last pulse and will be performed as per recommended clinical practice. Patients will then receive adjuvant systemic therapy as per standard of care and postoperative RT to the locoregional lymph nodes in case of nodal residual disease, if indicated.

开始日期2025-09-01

申办/合作机构

Azienda Ospedaliero-Universitaria Careggi

NCT06923527

/ Not yet recruiting临床2期IIT

A Single Arm Phase II Trial of Circulating Tumor DNA-guided Adjuvant Therapy With Elacestrant in Hormone Receptor Positive HER2 Negative Breast Cancers at Risk for Late Recurrence (CATE)

This is a single-arm, phase II study examining elacestrant in the adjuvant treatment of patients with ER+ breast cancer who test positive for circulating tumor DNA (ctDNA) during the screening period of the trial.

开始日期2025-06-01

申办/合作机构

Yale University

[+2]

NCT06201234

/ Recruiting临床2期

Phase II Study Evaluating the Addition of Elacestrant, an Oral Selective Estrogen Receptor Degrader (SERD), to Standard-of-care Olaparib in Patients with Hormone Receptor (HR)-positive, HER2-negative Locally Advanced or Metastatic Breast Cancer with GBRCA1/2 Mutations

Trial design:
Phase II, prospective, multi-center, randomized, open label, parallel group study in patients with HR-positive, HER2-negative locally advanced or metastatic breast cancer with gBRCA1/2 mutation, with 2:1 randomization into Arm A (olaparib + elacestrant) or arm B (olaparib). Treatment in either arm will be given until disease progression, unacceptable toxicity, withdrawal of patient´s consent to study participation, or end of study.
Trial population:
Patients with HR-positive, HER2-negative locally advanced or metastatic breast cancer with gBRCA1/2 mutation, with an indication for standard-of-care PARP inhibitor therapy and planned treatment with olaparib, an ECOG performance status of 0-2 and life expectancy of > 6 months, with normal bone marrow and kidney functions and no active or newly diagnosed central nervous system (CNS) metastases or symptomatic metastatic visceral disease at risk of life-threatening complications.
Interventions:
Patients randomized to Arm A will receive 600 mg olaparib daily and 400 mg elacestrant daily, while patients randomized to Arm B will receive 600 mg olaparib daily. Blood tests (hematology, biochemistry) will be performed at the beginning of every cycle, and imaging for tumor assessment (chest and abdominopelvic imaging) as well as QoL assessments will be performed every three months and in case of suspicion of progression/end of study.

开始日期2024-12-13

申办/合作机构

GBG Forschungs GmbH

[+1]

100 项与艾拉司群相关的临床结果

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100 项与艾拉司群相关的转化医学

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100 项与艾拉司群相关的专利（医药）

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104

项与艾拉司群相关的文献（医药）

2025-05-01·Molecular Diagnosis & Therapy

Clinical Actionability of Molecular Targets in Multi-Ethnic Breast Cancer Patients: A Retrospective Single-Institutional Study

Article

作者: Naghi, Leah ; Mortimer, Joanne ; Yost, Susan E ; Kang, Irene

BACKGROUND:

Precision oncology is making remarkable advancements in optimizing patient care by personalizing treatments. To date, the US Food and Drug Administration (FDA) has approved poly(ADP-ribose) polymerase inhibitors (PARPi) olaparib (Lynparza, AstraZeneca and Merck) and talazoparib (Talzenna, Pfizer Oncology Together™) for germline or somatic BRCA1/2-mutated metastatic breast cancer (BC) patients, and PI3K inhibitor alpelisib (Piqray, Novartis) plus fulvestrant for patients with hormone receptor-positive human epidermal growth factor receptor 2-negative (HR+HER2-) PIK3CA-mutated advanced BC. In addition, the FDA approved capivasertib (Trucap, AstraZeneca) for HR+HER2- locally advanced or metastatic BC patients with one or more AKT1, PIK3CA, or PTEN alterations. Finally, the FDA recently approved elacestrant (Orserdu, Stemline Therapeutics, Inc.) for postmenopausal patients with ER+ HER2- ESR1-mutated advanced or metastatic BC with disease progression following at least one line of endocrine therapy.

METHODS:

This study presents a single institutional retrospective review of genomic reports of patients with BC. Analysis of genomic reports of 1361 BC sequencing reports was performed for 1010 patients with BC from 2013 to 2023 (23% of patients had multiple reports). Eligible patients had at least one primary or metastatic tumor. Multiple sequencing platforms were used for FFPE specimens including Tempus xT targeted next-generation sequencing (NGS), Foundation One Medicine, HopeSeq, Ashion Analytics GEM ExTra, and Exact Sciences Oncomap. Liquid biopsies were performed by Guardant, Tempus, and Foundation One Medicine. Chart reviews were performed to collect patient characteristics. BRCA1/2-mutated, metastatic BC patients who initiated treatment with olaparib or talazoparib, and PIK3CA-mutated, HR+ metastatic BC patients who initiated treatment with alpelisib were reported. In addition, patients with ESR1 or AKT1/PIK3CA/PTEN mutations were identified. Clinical outcomes, including progression-free survival (PFS) and overall survival (OS) were analyzed for BRCA1/2 and PIK3CA-mutated patients who received PARPi or alpelisib. Survival curves were generated using the Kaplan Meier method.

RESULTS:

A cohort of 1010 BC patients with 1361 genomic reports was identified. A total of 935/1361 (69%) specimens were formalin-fixed paraffin-embedded (FFPE) tumor biopsies and 426/1361 (31%) were liquid biopsies. Receptor status included 65% HR+HER2-, 8% HR+HER2+, 4% HR-HER2+, and 23% TNBC. Racial and ethnic distribution of these patients included 50% non-Hispanic White, 26% Hispanic, 17% Asian, 6% African American, 1% other (Native Hawaiian or Other Pacific Islander, American Indian or Alaska Native, or unknown). Sequencing platforms included 30% Tempus xT, 31% Foundation One, 10% HopeSeq, 20% GEM ExTra, and 9% Exact Sciences. Liquid biopsies included 79% Guardant, 20% Tempus, and 1% Foundation One. Of 1010 patients, the most common mutations were TP53 (44%), PIK3CA (38%), ESR1 (14%), PTEN (12%), CCND1 (11%), FGFR1 (10%), CDH1 (10%), ERBB2 (9%), MYC (9%), FGF3 (8%), GATA3 (8%), FGF19 (8%), FGF4 (7%), ARID1A (6%), RB1 (5%), BRCA2 (5%), MAP3K1 (4%), AKT1 (4%), NF1 (4%), MLL3 (4%), ZNF703 (4%), CDKN2A (4%), BRCA1 (4%), MCL1 (3%), ATM (3%), PALB2 (1%), and CHEK2 (1%). The majority of reports with tumor mutation burden (TMB) results (97%) had low or intermediate TMB. A total of 784 actionable mutations in 1010 patients were reported, including 381/1010 (38%) PIK3CA; 144/1010 (14%) ESR1; 122/1010 (12%) PTEN; 48/1010 (5%) BRCA2; 36/1010 (4%) BRCA1; 41/1010 (4%) AKT1; and 12/1010 (1%) PALB2. Of the 96/1010 (10%) patients with BRCA1, BRCA2, or PALB2 mutations not including variants of uncertain significance (VUS), 33/96 (34.4%) received olaparib and 3/96 (3%) received talazoparib in the metastatic setting, and 28 were eligible for response (one had toxicity, two were lost to follow-up, and two went to hospice). Median PFS was 9.0 months and median OS was 21.8 months for patients receiving PARPi. Of the 381/1010 (38%) patients with PIK3CA mutations, 84/381 (22%) received alpelisib and 41 were eligible for response (22 had toxicity, 13 were discontinued, six were lost to follow-up, and two went to hospice). Median PFS was 7.9 months and median OS was 31.2 months for patients receiving alpelisib. A total of 544/1010 (54%) patients had AKT1, PIK3CA, or PTEN mutations which are now FDA approved for capivasertib in HR+HER2- metastatic BC patients. In addition, 144/1010 (14%) patients had ESR1 mutations which are FDA approved for elacestrant in HR+HER2- metastatic BC patients.

CONCLUSIONS:

In this study, a total of 784 clinically actionable mutations were reported for 1010 patients with genomic sequencing. Of these, 96/1010 (10%) patients had at least one actionable mutation in homologous recombination repair genes (BRCA1, BRCA2, PALB2) and 36/96 (37.5%) patients received PARP inhibitors (33 olaparib and three talazoparib). In addition, 381/1010 (38%) patients had at least one clinically actionable PIK3CA mutation, and 84/381 (22%) received alpelisib. Additionally, 544/1010 (54%) of patients had either AKT1 (41/1010), PIK3CA (381/1010), or PTEN (122/1010) alterations that were FDA approved in November 2023 for capivasertib in the treatment of HR+HER2- metastatic BC (MBC) patients. Furthermore, 144/1010 (14%) patients in this study had at least one ESR1 mutation, a clinically actionable mutation that was FDA approved in January 2023 for elacestrant in the treatment of ER+HER2- MBC patients (44% detected by liquid biopsy). Future studies are needed to determine the efficacy of elacestrant and capivasertib for patients with these mutations, and to tailor strategies for optimal patient quality of life and cancer outcome.

2025-04-01·CANCER TREATMENT REVIEWS

Post-progression treatment options after CDK4/6 inhibitors in hormone receptor-positive, HER2-negative metastatic breast cancer

Review

作者: Sahin, Taha Koray ; Aksoy, Sercan ; Guven, Deniz Can ; Rizzo, Alessandro

The combination of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) and endocrine therapy (ET) is the standard first-line treatment for hormone receptor-positive (HR + ) and HER2-negative metastatic breast cancer (mBC). Despite their efficacy, resistance inevitably develops, necessitating alternative therapeutic strategies post-progression. This review explores current and emerging treatment options following progression on CDK4/6i, focusing on endocrine therapies, targeted therapies, combination approaches, and the continued use of CDK4/6i. Endocrine therapies, including fulvestrant and novel oral selective estrogen receptor degraders (SERDs) like elacestrant, show promise, especially in patients with ESR1 mutations. Targeted therapies such as PI3K/AKT/mTOR inhibitors, exemplified by alpelisib and capivasertib, offer potential by addressing downstream signaling pathways involved in resistance. Additionally, FGFR inhibitors like erdafitinib are under investigation for their role in overcoming specific resistance mechanisms. Combination strategies involving CDK4/6 inhibitors with immune checkpoint inhibitors or other targeted agents are also being explored, with early trials suggesting possible synergistic effects, although further validation is required. Continuation of CDK4/6 inhibitors beyond progression has shown potential benefits in selected patients, but the data are heterogeneous, and further studies are needed to clarify their role. While chemotherapy remains a standard option for patients who progress on these treatments, the goal is to delay its use through the effective utilization of endocrine and targeted therapies. Understanding resistance mechanisms and tailoring treatment to individual patient profiles is crucial for optimizing outcomes. Ongoing clinical trials are expected to provide deeper insights, guiding the development of more effective post-progression therapeutic strategies. This evolving landscape highlights the need for continuous research and individualized patient care to improve survival and quality of life in HR + mBC patients.

2025-04-01·CLINICAL CANCER RESEARCH

Elacestrant in Women with Estrogen Receptor–Positive and HER2-Negative Early Breast Cancer: Results from the Preoperative Window-of-Opportunity ELIPSE Trial

Article

作者: Bellet, Meritxell ; Cortadellas, Tomás ; Gonzalez-Farré, Xavier ; Muñoz-Mateu, Montserrat ; Falato, Claudette ; Siso, Christian ; Pascual, Tomás ; Amillano, Kepa ; Bergamino, Milana A. ; Luna, Miguel A. ; Espinosa Guerrero, Alejandra ; Salvador, Fernando ; Cebrecos, Isaac ; Galván, Patricia ; Ferrero-Cafiero, Juan M. ; Sanfeliu, Esther ; Prat, Aleix ; Margelí Vila, Mireia ; Sanchez-Bayona, Rodrigo ; Vidal, Maria ; Pare, Laia

Abstract:

Purpose::

Elacestrant has shown significantly prolonged progression-free survival compared with standard-of-care endocrine therapy in estrogen receptor–positive (ER-positive), HER2-negative metastatic breast cancer, whereas potential benefit in early-stage disease requires further exploration. The SOLTI-ELIPSE window-of-opportunity trial investigated the biological changes induced by a short course of preoperative elacestrant in postmenopausal women with early breast cancer.

Patients and Methods::

Eligible patients with untreated T1c (≥1.5 cm)-T3, N0, ER-positive/HER2-negative breast cancer with locally assessed Ki67 ≥10% received elacestrant at a daily dose of 345 mg for 4 weeks. The primary efficacy endpoint was complete cell cycle arrest, defined as Ki67 ≤2.7%, on day 28.

Results::

Overall, 22 patients were evaluable for the primary endpoint. Elacestrant was associated with a complete cell cycle arrest rate of 27.3% and a statistically significant Ki67 geometric mean change of −52.9% (P = 0.007; 95% confidence interval, −67.4 to −32.1). Notably, the treatment with elacestrant led to a shift toward a more endocrine-sensitive and less proliferative tumor phenotype based on PAM50-based gene signatures. Elacestrant increased the expression of immune-response genes (GZMB, CD4, and CD8A) and suppressed proliferation and estrogen-signaling genes (MKI67, ESR1, and AR). These biological changes were independent of the levels of Ki67 suppression on day 28. The most common adverse events were grade 1 anemia (21.7%), hot flushes (8.7%), constipation (8.7%), and abdominal pain (8.7%). One patient experienced a grade 3 cutaneous rash, leading to treatment discontinuation. No other serious adverse events were reported.

Conclusions::

Preoperative treatment with elacestrant in early breast cancer demonstrated relevant biological and molecular responses and exhibited a manageable safety profile. These findings support further investigation of elacestrant in the early setting.

225

项与艾拉司群相关的新闻（医药）

2025-06-09

·CPHI制药在线

全球首款PROTAC来袭！辉瑞/Arvinas递交乳腺癌新药上市申请，开启靶向蛋白降解新时代！

关注并星标CPHI制药在线2025年6月6日，生物医药领域迎来历史性突破：Arvinas与辉瑞联合宣布向FDA提交了口服PROTAC药物Vepdegestrant（曾用名ARV-471）的新药申请，用于治疗携带ESR1突变的ER阳性/HER2阴性晚期或转移性乳腺癌患者。这标志着全球首个PROTAC药物正式冲击上市，一项曾被科学界视为“不可能”的技术终于从实验室走向临床。二十年磨一剑，蛋白降解技术终迎里程碑时刻。来源：Arvinas 官网PROTAC技术二十年磨一剑01PROTAC（蛋白降解靶向嵌合体）技术的故事始于2001年耶鲁大学Craig Crews教授实验室的一项开创性研究。当时研究人员设计出一种称为Protac-1的双功能分子——它的一端结合目标蛋白，另一端结合E3泛素连接酶，通过“拉近”两者促使目标蛋白被标记降解。“未来，这一方法有望用于让蛋白出现有条件失活，以及降解导致疾病的蛋白。”该团队在论文摘要中写道。技术转折点出现在2008年：Crews团队成功开发出首个小分子PROTAC，它能特异性结合雄激素受体和E3连接酶MDM2。这一突破解决了早期PROTAC依赖多肽而难以成药的关键瓶颈。2013年，Crews教授联合创办Arvinas公司，开始将这一技术推向临床应用。面对科学界的质疑，Arvinas选择从成熟的靶点——雌激素受体（ER）和雄激素受体（AR）切入，这正是后来Vepdegestrant的雏形。2021年，辉瑞以高达24亿美元的合作协议（6.5亿预付款+14亿里程碑+3.5亿股权）加入开发行列，成为PROTAC技术产业化的关键助推力。临床数据解读：Vepdegestrant如何破解耐药困局？02此次NDA申请主要基于III期VERITAC-2研究的积极结果。这项随机、开放标签、多中心试验聚焦于既往接受过内分泌治疗进展的ER+/HER2-晚期乳腺癌患者，特别是在CDK4/6抑制剂治疗后失败的难治人群。疗效数据亮点突出：结果显示，对于携带 ESR1 突变的 ER+/HER2- 晚期乳腺癌亚组，Vepdegestrant 对比氟维司群显示出具有统计学意义和临床价值的 PFS 改善，与氟维司群相比，Vepdegestrant 将疾病进展或死亡风险降低了 43%。经 BICR 评估，Vepdegestrant 组的中位 PFS 为 5.0 个月，氟维司群组为 2.1 个月。来源：参考文献2次要终点分析进一步验证了 Vepdegestrant 在 ESR1 突变亚组中的疗效优势，Vepdegestrant 组的临床获益率（CBR）达 42.1%，显著高于氟维司群组的 20.2%；ORR 同样表现出显著优势，两组 ORR 分别为 18.6% vs. 4.0%。OS 的探索性分析显示，当前数据尚未达到预设成熟度。来源：参考文献2安全性方面，Vepdegestrant表现出良好的耐受性。最常见的不良事件为疲劳（26.6%）和转氨酶升高（14.4%），3级以上治疗相关不良事件发生率为23.4%，因不良事件停药率仅2.9%，为长期用药提供了可能。PROTAC为何能超越传统疗法？03与传统内分泌治疗相比，Vepdegestrant实现了三大突破：作用机制革命：PROTAC不是简单的抑制剂，而是通过泛素-蛋白酶体系统直接降解靶蛋白。它像“智能运输车”一样，一端结合靶蛋白（ER），另一端招募E3泛素连接酶（主要是CRBN），形成三元复合物，给ER打上“降解标签”。克服耐药突变：传统内分泌治疗（如氟维司群）对ESR1突变效果有限，而Vepdegestrant能有效降解野生型和突变型ER蛋白。早期研究显示它可使肿瘤ER水平降低高达90%。持久反应特性：由于降解作用具有“事件驱动”特性（一个PROTAC分子可循环降解多个靶蛋白），理论上比抑制剂需要持续占据靶点更具优势。这在Ib期联合哌柏西利研究中得到印证：ESR1突变亚组中位PFS达13.7个月，反应持续时间14.6个月。“Vepdegestrant不仅是一款药，更是一项可组合的技术，将重新定义耐药性乳腺癌治疗。”一位意大利肿瘤科医生如此评价。商业棋局：机遇与挑战并存04从商业布局看，辉瑞对Vepdegestrant的规划极具战略眼光：首选获批适应症瞄准CDK4/6抑制剂治疗后进展的ESR1突变人群——这类患者二线治疗选择有限，预后极差，当前标准治疗的中位PFS仅约3-4个月。同时推进VERITAC-3研究，探索Vepdegestrant+哌柏西利一线治疗ER+/HER2-乳腺癌。Ib期数据显示，无论ESR1状态，联合治疗的临床获益率均超60%，中位PFS达11.2个月。在中国，辉瑞已启动VERITAC-2和VERITAC-3研究，分别由复旦大学附属肿瘤医院胡夕春教授和中国医学科学院肿瘤医院徐兵河教授领衔，计划在中国入组177人。市场研究机构预测，到2030年，Vepdegestrant在G7国家的年销售额有望达到11.9亿美元。其成功关键在于能否从后线治疗向一线扩展——一线ER阳性/HER2阴性乳腺癌患者数量是二/三线患者的近两倍（G7国家年新增约11.5万 vs 9万例）。Vepdegestrant的申报只是PROTAC革命的起点。目前全球已有365个在研PROTAC药物，覆盖124个靶点和84种适应症。中国力量在这一领域表现抢眼：药明康德已为全球66%的蛋白降解公司提供服务，支持超100款PROTAC分子开发，其中20个进入临床阶段。而同时，PROTAC技术虽前景广阔，但仍面临多重挑战：尽管在ESR1突变患者中数据优异，但ITT人群未达统计学显著性（3.7 vs 3.6个月，HR=0.81）。这提示我们需要更精准的生物标志物筛选策略。 Vepdegestrant将面临口服SERD（如艾拉司群、camizestrant）和CERAN（如palazestrant）的激烈竞争。其差异化优势在于降解更彻底和克服耐药突变的潜力。当前PROTAC分子量普遍较大（700-1000 Da），影响口服生物利用度。新一代技术如CLIPTAC（点击化学自组装）有望解决这一难题。预计Vepdegestrant2027年进入中国。中国药企如开拓药业已布局外用PROTAC药物GT20029（治疗雄激素性脱发），但系统给药的PROTAC研发仍需突破。结语：蛋白降解时代的真正启航05回望PROTAC技术从概念到临床的二十年历程，Vepdegestrant的上市申请不仅代表一款新药的诞生，更标志着靶向蛋白降解领域的成人礼。正如丹娜-法伯癌症研究所的Eric Fischer教授所言：“利用口服小分子去降解蛋白质，可以让科学家摆脱‘可成药性’的束缚，真正思考哪些靶点能够最大程度地改变疾病进程。”随着全球首款PROTAC药物审批进程的启动，一个能够靶向“不可成药”靶点、克服耐药困境的新时代已经到来。未来十年，我们有望看到蛋白降解技术从肿瘤扩展到神经退行性疾病、自身免疫病等更广阔领域，最终实现从“不可成药”到“万物可降解”的医学革命。参考文献： 1.Arvinas & Pfizer.*Vepdegestrant NDA Submission Based on VERITAC-2 Phase 3 Results* 2.The New England Journal of Medicine.Vepdegestrant, a PROTAC Estrogen Receptor Degrader, in Advanced Breast Cancer. (2025-06-02). 3.Arvinas.*Phase 1 Data of ARV-471: ER Degradation up to 90% and CBR of 41%*. (2023-08-29). 4.Arvinas 官网END【企业推荐】来源：CPHI制药在线声明：本文仅代表作者观点，并不代表制药在线立场。本网站内容仅出于传递更多信息之目的。如需转载，请务必注明文章来源和作者。投稿邮箱：Kelly.Xiao@imsinoexpo.com▼更多制药资讯，请关注CPHI制药在线▼点击阅读原文，进入智药研习社~

蛋白降解靶向嵌合体临床3期临床结果并购

2025-06-03

·BiG生物创新社

2025ASCO研究集锦速报！

2025ASCO如约而至，再次迎来全球肿瘤研究领域的高光时刻，简要整理共飨同仁！本文导读：01 肺癌1.1 SACHI研究：赛沃替尼+奥希替尼对比化疗挑战EGFR-TKI耐药伴Met扩增肺癌成功1.2 HERTHEA-Lung02研究：HER3 ADC治疗TKI耐药EGFR突变NSCLC1.3 OptiTROP-Lung03研究：新款TROP2 ADC挑战TKI和铂类化疗耐药晚期肺癌成绩优异1.4 CAMPASS研究：PDL1单抗联合安罗替尼对比K药一线治疗PDL1阳性肺癌告捷！1.5 SOLO-1研究：sevabertinib BAY2927088治疗HER2突变NSCLC1.6 REZILIENT1研究：Zipalertinib治疗经治EGFR 20ins肺癌，ORR35%1.7 EGFR 20ins和HER2 肺癌药物进展盘点1.8 ALNEO研究：阿来替尼围手术期处理III期ALK阳性NSCLC，MPR42%1.9 InTRist研究：特瑞普利单抗加持大块型III期肺癌同步放化疗成绩斐然1.10 2SMALL研究：卢比替定联合T药二线治疗晚期SCLC，ORR 40.4%。1.11 DeLLphi-303研究：Tarlatamab联合PDL1单抗尝试SCLC维持治疗获初步成绩1.12 CD3/DLL3/DLL3三特异性抗体ZG006三线治疗SCLC，ORR 66.7%，DCR 92.6%1.13 靶向DLL3的BITE药物的进展汇总1.14 KRYSTAL-7研究：adagrasib联合K药治疗KRAS G12C突变肺癌，有效率44%1.15 Checkmate77T研究：O药围手术期治疗疗效更新1.16 EGFR/HER3双抗ADC新药BL-B01D1挑战EGFR非经典突变获佳绩!1.17 C-met ADC Tliso-V/MYTX-011治疗met过表达肺癌1.18 CHRYSALIS研究最终结果：埃万妥单抗治疗MET 14突变肺癌，PFS 5.3月，OS 15.8月。1.19 EGFR-TKI耐药后的处理方向1.20 小细胞肺癌的治疗路线1.21 EGFR突变肺癌的一线考虑（MARIPOSA/FLAURA2）02 乳腺癌2.1 OptiTROP-Breast05研究：新型TROP2 ADC Sac-TMT一线治疗晚期TNBC2.4 FINER研究：AKT抑制剂联合氟维司群二线治疗ER+HER2-乳癌2.5 VERITAC-2研究：首款雌激素受体蛋白降解剂挑战难治HR+HER2-乳癌获突破2.6 SERENA-6研究：雌激素受体降解剂camizestrant联合CDK4/6抑制剂2.7 乳癌内分泌耐药解决新方向：KAT6抑制剂2.8 内分泌+CDK4/6抑制剂进展后的处理总结2.9 HR阳性乳癌整体治疗策略2.10 新的HR+治疗策略2.11 HER2阳性乳癌的治疗策略2.12 CDK4/6抑制剂进军三阳乳癌一线获佳绩2.13 PD1+贝伐+铂治疗三阴乳癌脑转移，颅内有效率77%。2.14 口服紫杉醇对比静脉紫杉醇治疗乳腺癌，疗效不输03 消化道肿瘤3.1 BREAKWATER研究：康菲替尼+西妥昔单抗+mFOLFOX6对比标准治疗3.2 CheckMate 8HW研究：O+Y双免成就MSI-H/dMMR晚期肠癌新一线标准3.3 晚期结直肠癌的一线精准治疗更替3.4 ATOMIC研究：免疫T药+mFOLFOX6辅助治疗dMMR的III期肠癌，DFS提升3.5DESTINY-Gastric04研究：DS8201成功挑战HER2+胃癌二线3.6 Checkmate577研究：O药辅助治疗食管癌，OS有改善趋势3.7LEAP015研究：仑伐替尼+K药+化疗治疗初治晚期胃癌3.8 CodeBreak101研究：索托拉西布+帕尼单抗+FOLFIRI3.9 ANCHOR III期研究：安罗替尼+CapeOx对比贝伐单抗+CapeOx3.10 LOXO-RAS-20001研究：二代KRAS G12C抑制剂联合西妥昔单抗3.11 MATTERHORN研究：免疫Imfinzi（I药）围手术期处理无转移的II-Iva期胃癌，获阳。3.12 1801 Part3B研究：GSK-3β抑制剂联合化疗提升胰腺癌总生存3.13 PANOVA3研究：肿瘤电场疗法联合化疗提升总生存3.14 Claudin18.2 CART治疗晚期胃癌3.15 局晚期直肠癌：放化疗加上PD1单抗，pCR提升（59%：33%）3.16 肠癌治疗策略3.17 胆管癌治疗策略3.18ctDNA对肠癌治疗的预后指导意义3.19 结肠癌腹膜转移：围手术期化疗+细胞减灭术+腹腔热灌注化疗3.20 胃肠肿瘤的CAR-T和TC04 泌尿系统肿瘤4.1 SURE02研究：TROP2 ADC SG联合K药新辅助治疗肾癌，CR率44.4%4.2 肾癌新方向：HIF-2a抑制剂4.3 9MW2821研究：Nectin4 ADC联合PD1一线治疗尿路上皮癌，ORR 80%4.4 TALAPRO-2研究：恩杂鲁胺联合PARP抑制剂在非HRR前列腺癌人群的获益性4.5 膀胱癌的ADC药物疗效对比4.6 放射性配体疗法177LuPSMA联合双免治疗前列腺癌4.7 膀胱癌治疗路线4.8 前列腺癌治疗路线05 ADC5.1 TQB2102：双表位HER2 ADC疗效初现5.2 靶向HER3 ADC新药DB-13105.3 ADC总结06 其他癌肿6.1 SUPRAME研究：靶向PRAME的TCR-T细胞治疗免疫耐药黑色素瘤，ORR56%，可期。6.2 三项头颈鳞癌同步放化疗+免疫的研究对比6.3 NIVOPOSTOP研究：O药联合放化疗辅助治疗头颈鳞癌，DFS提升。6.4 PD-1和VEGF双靶点药物HB0025治疗子宫内膜癌，ORR 80% 01 肺癌 1.1 SACHI研究：赛沃替尼+奥希替尼对比化疗挑战EGFR-TKI耐药伴Met扩增肺癌成功MET扩增是EGFR-TKI耐药的原因之一，为此，MET抑制剂赛沃替尼一直在该领域探索，此次III期SACHI结果公布，对于EGFR突变一线TKI耐药后MET扩增（非T790突变）的晚期非小细胞肺癌患者，接受赛沃替尼+奥希替尼治疗，对比化疗，ORR：58%：34%，PFS 8.2：4.5月（HR 0.34），OS 未成熟，但HR0.84（40%事件数）。其中对于一代二代TKI耐药的患者PFS 9.9：5.4月，对于三代TKI耐药的患者PFS 6.8：3.0月（HR 0.32），脑转移患者亦有获益。1.2 HERTHEA-Lung02研究：HER3 ADC治疗TKI耐药EGFR突变NSCLC2023年12月，HER3 ADC药物Patritumab deruxtecan基于HERTHENA-Lung01结果，获得FDA加速获批，用于TKI和铂类治疗进展的EGFR突变NSCLC，ORR 29.8%，PFS 5.5月，OS 11.9月。此次ASCO公布了HERTHENA-Lung02研究的头对头对比结果，显示，对于既往使用过三代TKI耐药的EGFR突变晚期非鳞NSCLC患者，与铂类化疗相比，PFS 5.8：5.4月（HR 0.77，P=0.011），OS 16.0：15.9月（HR 0.98），无改善。1.3 OptiTROP-Lung03研究：新款TROP2 ADC挑战TKI和铂类化疗耐药晚期肺癌成绩优异Sac-TMT是一款新型TROP2抑制剂，借鉴前辈Patritumab deruxtecan的上市思路，以TKI和铂类化疗耐药的EGFR敏感突变晚期非鳞NSCLC患者为研究对象，与多西他赛进行头对头比较，ORR 45.1%：15.6%，PFS 6.9：2.8月，OS尚未达到，HR 0.49。完胜，且比Patritumab deruxtecan更优，TROP2界的黑马，该药此次在TNBC也有优秀数据披露，见乳癌章节。1.4 CAMPASS研究：PDL1单抗联合安罗替尼对比K药一线治疗PDL1阳性肺癌告捷！K药是目前PDL1≥1%的无驱动基因突变晚期NSCLC的标准治疗，是否会有更高的疗效方案，此次国内专家带来的CAMPASS研究给出了答案，采用PDL1单抗贝莫苏拜单抗联合抗血管小分子药物安罗替尼头对头与K药对比，PFS 11.0:7.1月，HR 0.70，在PDL1≥50%的高表达人群中，PFS 13.3:7.2，HR 0.60，为PDL1阳性NSCLC带来新的一线治疗标准，有望改变肺癌治疗格局。1.5 SOLO-1研究：sevabertinib BAY2927088治疗HER2突变NSCLCSevabertinib是一款HER2抑制剂，一线治疗HER2突变晚期NSCLC，ORR 59.0%，对于经治HER2突变，ORR 60.5%，基于如此优秀的结果，III期SOLO-2研究正在开展。1.6 REZILIENT1研究：Zipalertinib治疗经治EGFR 20ins肺癌，ORR35%对于既往只接受过化疗进展的EGFR20ins，ORR 40%，对于既往使用过埃万妥单抗或其他HER2 TKI药物进展的，ORR24%。1.7 EGFR 20ins和HER2 肺癌药物进展盘点1.8 ALNEO研究：阿来替尼围手术期处理III期ALK阳性NSCLC，MPR42%对于ALK阳性的初治局晚III期NSCLC，采用阿来替尼新辅助治疗2周期，序贯手术治疗+辅助治疗至24周期，主要病理缓解率（MPR）为42%，86% R0切除。III期开展中。1.9 InTRist研究：特瑞普利单抗加持大块型III期肺癌同步放化疗成绩斐然对于突变基因阴性的III期不可切除的NSCLC，同步放化疗+免疫治疗已经成为标准治疗。此次，特瑞普利单抗挑选了III期中大块型（肿瘤≥5cm或淋巴结≥2cm）的NSCLC，在同步放化疗之前增加了2周期的PD1+化疗治疗，对比单纯的化疗，PFS 85.8：54.5月，HR=0.26，ORR：77.8%：40.0%。1.10 2SMALL研究：卢比替定联合T药二线治疗晚期SCLC，ORR 40.4%。既往未接受免疫治疗的受试者ORR44.1%，既往接受过免疫治疗的受试者，ORR 37.3%，总体中位PFS 4.6月，OS 10.1月。1.11 DeLLphi-303研究：Tarlatamab联合PDL1单抗尝试SCLC维持治疗获初步成绩既往基于DeLLphi-301研究，靶向CD3/DLL3的双特异性抗体（BITE）Tarlatamab获批用于经治广泛期SCLC，ORR 40%。此次Tarlatamab公布了DeLLphi-303研究结果，探索一线化免治疗后，采用Tarlatamab联合PDL1作为维持治疗的疗效。DCR64.5%，DCR维持时间7.2个月或更长，初步疗效支撑III期DeLLphi-305研究的开展。1.12 CD3/DLL3/DLL3三特异性抗体ZG006三线治疗SCLC，ORR 66.7%，DCR 92.6%1.13 靶向DLL3的BITE药物的进展汇总1.14 KRYSTAL-7研究：adagrasib联合K药治疗KRAS G12C突变肺癌，有效率44%1.15 Checkmate77T研究：O药围手术期治疗疗效更新既往基于Checkmate77T研究，O药已获批II-IIIB期无EGFR/ALK突变的NSCLC围手术期治疗适应症（O+化疗新辅助4周期+手术+O药辅助至13个周期），此次公布了更新结果，EFS 46.6：16.9月，ctDNA/pCR与EFS相关，OS未达到，但有获益趋势（HR 0.85）。1.16 EGFR/HER3双抗ADC新药BL-B01D1挑战EGFR非经典突变获佳绩!多靶点ADC已成为ADC领域的新发展方向，此次国内一款EGFR/HER3 ADC新药（毒性载荷TOPi）BL-B01D1以肺癌非经典EGFR突变患者为切入点，获得亮眼成绩：治疗EGFR20ins肺癌，ORR 69.2%，中位PFS 10.5个月；治疗HER2突变肺癌，ORR 52.9%，DOR 5.7个月；治疗KRAS/BRAF/MET突变肺癌，ORR40%；整体ORR 46.2%，PFS 5.7个月。为非EGFR经典突变人群带来新的药物方向，尤其在EGFR 20ins领域值得进一步研究。该药在EGFR突变肺癌既往研究获得了63.2%的ORR。1.17 C-met ADC Tliso-V/MYTX-011治疗met过表达肺癌1.18 CHRYSALIS研究最终结果：埃万妥单抗治疗MET 14突变肺癌，PFS 5.3月，OS 15.8月。1.19 EGFR-TKI耐药后的处理方向1.20 小细胞肺癌的治疗路线1.21 EGFR突变肺癌的一线考虑（MARIPOSA/FLAURA2） 02 乳腺癌 2.1 OptiTROP-Breast05研究：新型TROP2 ADC Sac-TMT一线治疗晚期TNBC既往TROP2 ADC Sacituzumab打开了经治三阴乳癌的市场（ORR 35%，PFS 5.6月，OS 12.1月），此次新款TROP2 ADC Sac-TMT在初治三阴乳癌给出亮眼成绩，ORR 70%，PFS 13.4月。2项III期研究正在开展中，有望带来TNBC新的变革。2.2 ASCENT04研究：TROP2 ADC SG联合K药成就PDL1+三阴乳癌新一线标准对于PDL1+（CPS≥10）的三阴乳癌，免疫+化疗是目前标准一线方案，此次ASCO公布的ASCENT04研究，继续升级，采用免疫联合ADC（TROP2）的方案，结果显示，对比化疗联合免疫，PFS 11.2：7.8月，HR 0.65，P<0.001，有望成为新的三阴乳癌一线标准。OS 未成熟，但已见获益趋势（HR 0.89）。2.3 INAVO120研究：PIK3CA抑制剂inavolisib+帕博西利+氟维司群30%-40%的HR+/HER2-乳癌具有PI3K的突变，此次INAVO120研究首次将PI3K抑制剂提到一线，联合CDK4/6抑制剂及氟维司群治疗初治PIK3CA突变的HR+/HER2-乳癌，对比不联合，PFS 17.2：7.3月。催生出了新的靶向导引人群的新一线标准。2.4 FINER研究：AKT抑制剂联合氟维司群二线治疗ER+HER2-乳癌对于既往一线AI+CDK4/6抑制剂耐药的HER+HER2-乳癌患者，采用AKT抑制剂Ipatasertib联合氟维司群治疗，相比单纯的氟维司群，PFS 5，32：19.4月，HR 0.61，P=0.0007。在伴有AKT通路突变的乳癌患者中，获益更大，HR 0.47。2.5 VERITAC-2研究：首款雌激素受体蛋白降解剂挑战难治HR+HER2-乳癌获突破2.6 SERENA-6研究：雌激素受体降解剂camizestrant联合CDK4/6抑制剂另一款口服雌激素受体降解剂camizestrant在ESR1突变后使用，可下降56%的疾病进展风险，PFS 16：9.2个月。2.7 乳癌内分泌耐药解决新方向：KAT6抑制剂表观药物KAT6抑制剂，可以靶向抑制KAT6A/6B，后者在乳癌中的扩增表达率10%-15%，此次KAT6抑制剂联合氟维司群治疗既往CDK4/6抑制剂治疗进展的HR+/HER2-的晚期乳癌，43例患者，ORR 37%，PFS 10.7月。为内分泌耐药乳癌治疗提出新方向。2.8 内分泌+CDK4/6抑制剂进展后的处理总结提出三个方向：①多项新药如艾拉司群获批用于氟维司群无法处理的ESR1突变；②新的PI3K选择性突变抑制剂；③CDK2+CDK4/6；除此上节提及的KAT6抑制剂也是方向之一。2.9 HR阳性乳癌整体治疗策略伴随DS8201在HER2低表达人群获益性的确立及TROP2 ADC的获批，HR+乳癌的后线治疗日益丰富。2.10 新的HR+治疗策略2.11 HER2阳性乳癌的治疗策略2.12 CDK4/6抑制剂进军三阳乳癌一线获佳绩内分泌治疗+CDK4/6抑制剂+赫塞汀一线治疗90例HR+/HER2+晚期乳癌，有效率61%，PFS 30月。为三阳乳癌一线纳入CDK4/6抑制剂拉开序幕。2.13 PD1+贝伐+铂治疗三阴乳癌脑转移，颅内有效率77%。2.14 口服紫杉醇对比静脉紫杉醇治疗乳腺癌，疗效不输 03 消化道肿瘤 3.1 BREAKWATER研究：康菲替尼+西妥昔单抗+mFOLFOX6对比标准治疗BRAF抑制剂康菲替尼+西妥昔单抗+mFOLFOX6对比标准治疗一线治疗BRAF V600E突变的晚期结直肠癌，ORR 65%：37%，PFS 12.8：7.1月，OS：30.3：15.1月。催生了BRAF V600E突变晚期结直肠癌的一线标准治疗。3.2 CheckMate 8HW研究：O+Y双免成就MSI-H/dMMR晚期肠癌新一线标准对于MSI-H/dMMR的晚期结直肠癌，进行O+Y双免对比化疗对比O药单药疗效对比，结果显示，在所有线数O+Y与O药ORR 71%：58%，PFS NR：39.3月，O+Y与化疗PFS 54.1：5.9月。3.3 晚期结直肠癌的一线精准治疗更替随着BRAF突变肠癌一线研究（BREAKWATER）的成功及O+Y双免在MSI-H肠癌一线研究（CheckMate 8HW）的成功，肠癌一线精准治疗局面正在形成。3.4 ATOMIC研究：免疫T药+mFOLFOX6辅助治疗dMMR的III期肠癌，DFS提升3年DFS率86.4%：76.6%，HR0.53.5 DESTINY-Gastric04研究：DS8201成功挑战HER2+胃癌二线对于HER2+胃癌，以曲妥珠单抗为基础的联合治疗是胃癌的一线标准，但是这类人群耐药后，并没有抗HER2的二线方案推荐，雷莫卢单抗联合紫杉醇是目前标准二线，此次DS8201与标准二线进行头对头比较，获得了OS（14.7：11.4月，HR 0.70）、PFS（6.7：5.6月，HR 0.74）及ORR（44.3%：29.1%）的全面优效，为晚期胃癌二线带来新的标准方案。3.6 Checkmate577研究：O药辅助治疗食管癌，OS有改善趋势对于II/III期可切除食管癌，在新辅助放化疗+手术R0切除后，采用O药辅助治疗16周，对比安慰剂，OS提升， 51.7：35.3月，HR 0.85，在CSP≥1的受试者，HR 0.79，鳞癌 HR 0.72。3.7 LEAP015研究：仑伐替尼+K药+化疗治疗初治晚期胃癌3.8 CodeBreak101研究：索托拉西布+帕尼单抗+FOLFIRI采用KRAS抑制剂索托拉西布sotorasib+EGFR单抗帕尼单抗panitumumab+FOLFIRI治疗KRAS G12C突变经治晚期结直肠癌，ORR 58%，DOR 6.6月，OS 15.6月。3.9 ANCHOR III期研究：安罗替尼+CapeOx对比贝伐单抗+CapeOx安罗替尼+CapeOx对比贝伐单抗+CapeOx一线治疗晚期结直肠癌，疗效相近，ORR（均为61%），PFS（7：6.9月）。提供新的用药模式。3.10 LOXO-RAS-20001研究：二代KRAS G12C抑制剂联合西妥昔单抗二代KRAS G12C抑制剂Olomorasib联合西妥昔单抗治疗 KRAS G12C突变肠癌，ORR 43%，DCR 92%，PFS 7.4月。当然市场目前期待如何处理继发耐药问题。3.11 MATTERHORN研究：免疫Imfinzi（I药）围手术期处理无转移的II-Iva期胃癌，获阳。对于无转移的II-Iva期胃癌，采用I药+FLOT新辅助2周期，手术，术后2周期I药+FLOT+I药维持10周期，相比只是淡出FLOT，2年EFS 67%：59%，HR 0.71，2年OS率 76%：70%。3.12 1801 Part3B研究：GSK-3β抑制剂联合化疗提升胰腺癌总生存Elraglusib是一款GSK-3β抑制剂，GSK-3是CD8+T细胞中PD-1基因表达的上游调节因子，并证明GSK-3抑制剂在控制肿瘤生长方面与抗PD-1阻断剂一样有效。本次公布的研究结果显示，Elraglusib联合GnP方案相比单纯GnP，具有OS的提升（10.1：7.2月）。3.13 PANOVA3研究：肿瘤电场疗法联合化疗提升总生存3.14 Claudin18.2 CART治疗晚期胃癌3.15 局晚期直肠癌：放化疗加上PD1单抗，pCR提升（59%：33%）3.16 肠癌治疗策略3.17 胆管癌治疗策略3.18 ctDNA对肠癌治疗的预后指导意义ctDNA被证明是III期可切除肠癌的不良预后因素，但是DYNAMIC-III研究显示，对ctDNA阳性人群进行升级治疗，相比标准治疗，未见RFS的提升（29：36月）。3.19 结肠癌腹膜转移：围手术期化疗+细胞减灭术+腹腔热灌注化疗腹膜转移在结肠癌患者中常见，相比单纯手术，手术围手术期进行化疗+细胞减灭术+腹腔热灌注化疗，PFS翻倍（14：7月），但OS获益趋势小（44：39月）。3.20 胃肠肿瘤的CAR-T和TC 04 泌尿系统肿瘤 4.1 SURE02研究：TROP2 ADC SG联合K药新辅助治疗肾癌，CR率44.4%4.2 肾癌新方向：HIF-2a抑制剂4.3 9MW2821研究：Nectin4 ADC联合PD1一线治疗尿路上皮癌，ORR 80%4.4 TALAPRO-2研究：恩杂鲁胺联合PARP抑制剂在非HRR前列腺癌人群的获益性4.5 膀胱癌的ADC药物疗效对比4.6 放射性配体疗法177LuPSMA联合双免治疗前列腺癌对比单纯177LuPSMA，pPFS HR 0.53。4.7 膀胱癌治疗路线4.8 前列腺癌治疗路线 05 ADC 5.1 TQB2102：双表位HER2 ADC疗效初现TQB2102是一款双表位HER2 （曲妥+帕妥）ADC（毒性载荷TOPi，DAR=6），治疗实体瘤，在HER2阳性乳癌，ORR 52%；在HER2低表达乳癌，ORR 47%；在HER2 3+肠癌，ORR 44%；在HER2阳性胃癌/胃食管结合部癌，ORR 40%。疗效均可看，值得关注。5.2 靶向HER3 ADC新药DB-1310DB-1310，一款靶向HER3的ADC药物（毒性载荷TOPi，DAR=8）治疗123例晚期实体瘤，ORR为31%，中位PFS 5.5个月；其中46例EGFR突变肺癌患者，ORR 44%。安全性良好。5.3 ADC总结部分会场对ADC的发展进行了讨论，看到了一些振奋的疗效例如HER3 ADC DB-1310，一些新的ADC正在探索中，提出未来ADC的发展方向：新的靶点、更强的结合力、新的毒素载荷、更强的入脑性。以HER3靶点药物目前的不俗表现，HER3靶点成为另一个“HER2“吗？新三款ADC安全性比较。 06 其他癌肿 6.1 SUPRAME研究：靶向PRAME的TCR-T细胞治疗免疫耐药黑色素瘤，ORR56%，可期。6.2 三项头颈鳞癌同步放化疗+免疫的研究对比6.3 NIVOPOSTOP研究：O药联合放化疗辅助治疗头颈鳞癌，DFS提升。6.4 PD-1和VEGF双靶点药物HB0025治疗子宫内膜癌，ORR 80%共建Biomedical创新生态圈！如何加入BiG会员？

ASCO会议抗体药物偶联物临床结果临床3期

2025-05-31

·PipelineReview

Arvinas and Pfizer's Vepdegestrant Significantly Improves Progression-Free Survival for Patients with ESR1-Mutant, ER+/HER2- Advanced Breast Cancer

NEW HAVEN, CT and NEW YORK, NY, USA I May 31, 2025 I Arvinas, Inc. (Nasdaq: ARVN) and Pfizer Inc. (NYSE: PFE) today announced detailed results from the Phase 3 VERITAC-2 clinical trial (NCT05654623) evaluating vepdegestrant monotherapy versus fulvestrant in adults with estrogen receptor-positive, human epidermal growth factor receptor 2-negative (ER+/HER2-) advanced or metastatic breast cancer (MBC) whose disease progressed following prior treatment with cyclin-dependent kinase (CDK) 4/6 inhibitors and endocrine therapy. These data, which were highlighted in the American Society of Clinical Oncology (ASCO ® ) press briefing and selected for Best of ASCO, will be presented today in a late-breaking oral presentation (Abstract LBA1000) and have been simultaneously published in the New England Journal of Medicine . In the trial, vepdegestrant demonstrated a statistically significant and clinically meaningful improvement in progression-free survival (PFS) among patients with an estrogen receptor 1 (ESR1) mutation, reducing the risk of disease progression or death by 43% compared to fulvestrant [Hazard Ratio (HR)=0.57 (95% CI 0.42–0.77); 2-sided P<0.001]. The median PFS, as assessed by blinded independent central review (BICR), was 5.0 months with vepdegestrant versus 2.1 months with fulvestrant. Investigator-assessed PFS was consistent with the BICR-assessed PFS. In patients with ESR1 mutations, vepdegestrant demonstrated a consistent PFS benefit over fulvestrant across all pre-specified subgroups. The trial did not reach statistical significance in improvement in PFS in the intent-to-treat (ITT) population, with a median PFS of 3.7 months for vepdegestrant versus 3.6 for fulvestrant [HR=0.83 (95% CI 0.68–1.02); 2-sided P=0.07]. “Many patients with ER+/HER2- metastatic breast cancer who progress on endocrine therapy have tumors with ESR1 mutations, which drive resistance to standard treatments,” said Erika P. Hamilton, M.D., Director, Breast Cancer Research, Sarah Cannon Research Institute, and a principal investigator of the VERITAC-2 trial. “The VERITAC-2 results are promising and suggest that vepdegestrant could offer a much-needed treatment option for these patients, with a low incidence of burdensome GI effects that can meaningfully affect daily life.” Vepdegestrant was generally well tolerated in the trial, with a safety profile consistent with what has been observed in previous studies, and mostly low-grade treatment-emergent adverse events (TEAEs). Rates and severity of gastrointestinal adverse events were low with vepdegestrant (nausea, 13.5%; vomiting, 6.4%; diarrhea, 6.4%). Grade 4 TEAEs were reported in 5 patients (1.6%) in the vepdegestrant arm versus 9 patients (2.9%) in the fulvestrant arm. The three most common TEAEs observed with vepdegestrant were fatigue (26.6%), increased alanine transaminase (ALT) (14.4%) and increased aspartate aminotransferase (AST) (14.4%). TEAEs leading to treatment discontinuation occurred in 2.9% of patients taking vepdegestrant versus 0.7% of patients taking fulvestrant. “Based on these strong data from VERITAC-2, we believe that vepdegestrant has the potential to be a best-in-class monotherapy treatment for patients in the second-line ESR1-mutant setting,” said John Houston, Ph.D., Chairperson, Chief Executive Officer and President at Arvinas. “We are excited to engage with regulatory authorities on next steps to potentially bring vepdegestrant to healthcare providers and their patients as swiftly as possible.” Overall survival (OS), the key secondary endpoint in VERITAC-2, was immature at the time of the analysis, with less than a quarter of the required number of events having occurred. Additional secondary endpoints include clinical benefit rate (CBR) and objective response rate (ORR) and duration of response by BICR. In patients with an ESR1 mutation, CBR was 42.1% with vepdegestrant versus 20.2% with fulvestrant [odds ratio 2.88 (95% CI: 1.57–5.39); nominal P<0.001] and ORR was 18.6% with vepdegestrant versus 4.0% with fulvestrant [odds ratio 5.45 (95% CI: 1.69–22.73); nominal P=0.001]. The median duration of response was not reached. “Patients whose tumors harbor ESR1 mutations can face a poor prognosis, often experiencing rapid disease progression on endocrine therapy,” said Johanna Bendell, M.D., Chief Oncology Development Officer, Pfizer. “These results highlight the important role vepdegestrant may play in combating ESR1 mutation treatment resistance for these patients.” Approximately 2.3 million new breast cancer diagnoses were reported globally in 2022, and it is estimated there will be nearly 320,000 new diagnoses in the United States in 2025. ER+/HER2- breast cancer accounts for approximately 70% of all cases. Nearly 30% of women initially diagnosed with early-stage breast cancer will ultimately develop metastatic disease, 1 with resistance to current standard-of-care treatments often emerging during first-line therapy, leading to disease progression. ESR1 mutations are a common cause of acquired resistance and are found in approximately 40% of patients in the second-line setting. 2,3,4 Vepdegestrant, an investigational oral PROTAC ER degrader for ER+/HER2- breast cancer being jointly developed by Arvinas and Pfizer, is designed to harness the body’s natural protein disposal system to specifically target and degrade the ER. These detailed results follow the March 2025 announcement of the topline results from VERITAC-2. The companies plan to submit a New Drug Application (NDA) for vepdegestrant to the U.S. Food & Drug Administration (FDA) in the second half of 2025. ASCO Presentation Details “Vepdegestrant, a PROTAC Estrogen Receptor Degrader, vs Fulvestrant in ER-Positive/Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer: Results of the Global, Randomized, Phase 3 VERITAC-2 Study” will be presented by Dr. Erika Hamilton, MD, Sarah Cannon Research Institute, in the Oral Abstract Session, Breast Cancer—Metastatic on Saturday, May 31, 1:15 – 4:15 p.m. CDT in Hall B1. Abstract LBA1000. Investor Call and Webcast Details Arvinas will host a conference call and webcast on June 2, 2025, at 8:00 a.m. ET to review these data. Participants are invited to listen by going to the Events and Presentation section under the Investors page on the Arvinas website at www.arvinas.com . A replay of the webcast will be available on the Arvinas website following the completion of the event and will be archived for up to 30 days. About the VERITAC-2 Clinical Trial The Phase 3 VERITAC-2 clinical trial ( NCT05654623 ) is a global randomized trial evaluating the efficacy and safety of vepdegestrant (ARV-471) as a monotherapy compared to fulvestrant in patients with ER+/HER2- advanced or metastatic breast cancer. The trial enrolled 624 patients at sites in 26 countries who had previously received treatment with a CDK4/6 inhibitor plus endocrine therapy. Patients were randomized 1:1 to receive either vepdegestrant once daily, orally on a 28-day continuous dosing schedule, or fulvestrant, administered intramuscularly on Days 1 and 15 of Cycle 1 and then on Day 1 of each 28-day cycle starting from Day 1 of Cycle 2. In the trial, 43% of patients (n=270) had ESR1 mutations detected. The primary endpoint was progression-free survival (PFS) in the ESR1-mutation and intent-to-treat populations as determined by blinded independent central review. Overall survival is the key secondary endpoint. About Vepdegestrant Vepdegestrant is an investigational, orally bioavailable PROteolysis TArgeting Chimera (PROTAC) protein degrader designed to specifically target and degrade the estrogen receptor (ER) for the treatment of patients with ER-positive (ER+)/human epidermal growth factor receptor 2 (HER2)-negative (ER+/HER2-) breast cancer. Vepdegestrant is being developed as a potential monotherapy for ER+/HER2- advanced or metastatic breast cancer with estrogen receptor 1 (ESR1) mutations in the second line-plus setting. In July 2021, Arvinas announced a global collaboration with Pfizer for the co-development and co-commercialization of vepdegestrant; Arvinas and Pfizer will share worldwide development costs, commercialization expenses, and profits. The U.S. Food and Drug Administration (FDA) has granted vepdegestrant Fast Track designation as a monotherapy in the treatment of adults with ER+/HER2- advanced or metastatic breast cancer previously treated with endocrine-based therapy. About Arvinas Arvinas (Nasdaq: ARVN) is a clinical-stage biotechnology company dedicated to improving the lives of patients suffering from debilitating and life-threatening diseases. Through its PROTAC protein degrader platform, Arvinas is pioneering the development of protein degradation therapies designed to harness the body’s natural protein disposal system to selectively and efficiently degrade and remove disease-causing proteins. Arvinas is currently progressing multiple investigational drugs through clinical development programs, including vepdegestrant, targeting the estrogen receptor for patients with locally advanced or metastatic ER+/HER2- breast cancer; ARV-393, targeting BCL6 for relapsed/refractory non-Hodgkin Lymphoma; and ARV-102, targeting LRRK2 for neurodegenerative disorders. Arvinas is headquartered in New Haven, Connecticut. For more information about Arvinas, visit www.arvinas.com and connect on LinkedIn and X . About Pfizer Oncology At Pfizer Oncology, we are at the forefront of a new era in cancer care. Our industry-leading portfolio and extensive pipeline includes three core mechanisms of action to attack cancer from multiple angles, including small molecules, antibody-drug conjugates (ADCs), and bispecific antibodies, including other immune-oncology biologics. We are focused on delivering transformative therapies in some of the world’s most common cancers, including breast cancer, genitourinary cancer, hematology-oncology, and thoracic cancers, which includes lung cancer. Driven by science, we are committed to accelerating breakthroughs to help people with cancer live better and longer lives. About Pfizer: Breakthroughs That Change Patients’ Lives At Pfizer, we apply science and our global resources to bring therapies to people that extend and significantly improve their lives. We strive to set the standard for quality, safety and value in the discovery, development and manufacture of health care products, including innovative medicines and vaccines. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as one of the world’s premier innovative biopharmaceutical companies, we collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For 175 years, we have worked to make a difference for all who rely on us. We routinely post information that may be important to investors on our website at www.pfizer.com . In addition, to learn more, please visit us on www.pfizer.com and follow us on X at @Pfizer and @Pfizer_News , LinkedIn , YouTube and like us on Facebook at Facebook.com/Pfizer . 1 Redig AJ, McAllister SS. Breast cancer as a systemic disease: a view of metastasis. J Intern Med . 2013;274(2):113-126. doi:10.1111/joim.12084. 2 Bidard F-C, et al. Elacestrant (oral selective estrogen receptor degrader) Versus Standard Endocrine Therapy for Estrogen Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Advanced Breast Cancer: Results From the Randomized Phase III EMERALD Trial. Journal of Clinical Oncology. 2022 May https://doi-org.libproxy1.nus.edu.sg/10.1200/JCO.22.00338 . 3 Kalinsky, K. Abemaciclib Plus Fulvestrant in Advanced Breast Cancer After Progression on CDK4/6 Inhibition: Results From the Phase III postMONARCH Trial. Journal of Clinical Oncology. 2024 Dec. https://pubmed-ncbi-nlm-nih-gov.libproxy1.nus.edu.sg/39693591/ . 4 Tolaney, S. et al. AMEERA-3: Randomized Phase II Study of Amcenestrant (Oral Selective Estrogen Receptor Degrader) Versus Standard Endocrine Monotherapy in Estrogen Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Advanced Breast Cancer. Journal of Clinical Oncology. https://ascopubs-org.libproxy1.nus.edu.sg/doi/full/10.1200/JCO.22.02746 . SOURCE: Arvinas

临床结果临床3期ASCO会议临床2期快速通道

100 项与艾拉司群相关的药物交易

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KEGG	Wiki	ATC	Drug Bank
D11671	艾拉司群	-	DB06374

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适应症	国家/地区	公司	日期
晚期乳腺癌	英国	Stemline Therapeutics, Inc.	2024-01-05
转移性乳腺癌	英国	Stemline Therapeutics, Inc.	2024-01-05
ER阳性/HER2阴性/ESR1突变乳腺癌	美国	Stemline Therapeutics, Inc.	2023-01-27

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适应症	最高研发状态	国家/地区	公司	日期
乳腺癌	申请上市	美国	Radius Pharmaceuticals, Inc.	2022-06-22
淋巴结阳性乳腺癌	临床3期	美国	Stemline Therapeutics, Inc.	2024-09-27
淋巴结阳性乳腺癌	临床3期	澳大利亚	Stemline Therapeutics, Inc.	2024-09-27
淋巴结阳性乳腺癌	临床3期	奥地利	Stemline Therapeutics, Inc.	2024-09-27
淋巴结阳性乳腺癌	临床3期	比利时	Stemline Therapeutics, Inc.	2024-09-27
淋巴结阳性乳腺癌	临床3期	加拿大	Stemline Therapeutics, Inc.	2024-09-27
淋巴结阳性乳腺癌	临床3期	捷克	Stemline Therapeutics, Inc.	2024-09-27
淋巴结阳性乳腺癌	临床3期	法国	Stemline Therapeutics, Inc.	2024-09-27
淋巴结阳性乳腺癌	临床3期	德国	Stemline Therapeutics, Inc.	2024-09-27
淋巴结阳性乳腺癌	临床3期	匈牙利	Stemline Therapeutics, Inc.	2024-09-27

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT06492616 (ELEGANT, ASCO2025)	临床3期	淋巴结阳性乳腺癌 \| ER阳性乳腺癌辅助 Ki67	-	Elacestrant	醖艱艱衊遞艱餘積膚壓(襯鬱糧簾夢夢廠齋構鹽) = 範淵簾壓襯築醖構糧鏇餘製繭積廠簾襯壓鑰鏇 (網夢鹹壓鑰選衊鏇獵獵 )	积极	2025-05-30
				Standard Endocrine Therapy (AI or tamoxifen)	醖艱艱衊遞艱餘積膚壓(襯鬱糧簾夢夢廠齋構鹽) = 繭淵襯鏇築衊夢廠襯糧餘製繭積廠簾襯壓鑰鏇 (網夢鹹壓鑰選衊鏇獵獵 )
NCT06382948 (ADELA, ASCO2025)	临床3期	ER阳性/HER2阴性/ESR1突变乳腺癌 \| HER2 阴性乳腺癌 \| ER阳性乳腺癌 ... ESR1-mutated tumors 更多	240	Elacestrant 345 mg + Everolimus 7.5 mg	廠鬱獵獵醖築願築鏇醖(鑰積壓製鹽蓋構衊鏇獵) = 製膚鹽顧憲淵製選範顧壓鏇構築廠遞夢衊鹽醖 (淵夢膚築醖艱獵淵窪積 ) 更多	积极	2025-05-30
NCT05563220 (ELEVATE, ASCO2025)	临床1/2期	ER阳性/HER2阴性乳腺癌	-	Elacestrant + Ribociclib	願餘醖獵鹹願獵艱築顧(願鹽廠窪膚鬱遞顧築廠) = 43% (7% ≥Gr3) with Ela + Eve 憲鬱範淵選憲構鑰鏇淵 (鹽願蓋遞網鹹餘膚獵窪 ) 更多	-	2025-05-30
				Elacestrant + Everolimus
NCT03778931 (EMERALD, ESMO_BC2025)	临床3期	转移性乳腺癌 ESR1	966	elacestrant (ESR1 mutation testing by liquid biopsy using ddPCR)	醖鏇蓋鑰鹹網觸願艱醖(醖窪構構夢鹽鹹獵淵積) = 遞蓋廠廠齋積鏇願鏇廠網鹹鹽醖遞鹹鹹鏇壓襯 (鹹膚淵鑰鹽鑰膚鏇壓齋, 33.2% ~ 39.4) 更多	积极	2025-05-14
NCT06492616 (ELEGANT, AACR2025)	临床3期	淋巴结阳性乳腺癌 \| ER阳性乳腺癌 ESR1	-	Elacestrant	壓膚製築鹹膚齋網鑰壓(憲獵餘衊構鬱蓋淵艱蓋): HR = 0.7 (95% CI, 0.55 ~ 0.88), P-Value = 0.0018	积极	2025-04-29
				Standard Endocrine Therapy (AI or tamoxifen)
SABCS2024 人工标引	N/A	ER阳性/HER2阴性乳腺癌 HER2 Negative	212	Elacestrant	壓遞鏇夢醖網獵顧觸齋(遞蓋製蓋繭觸鑰獵鏇壓) = 糧網願願窪淵鹽簾醖夢願鬱構鏇觸醖鏇構範獵 (壓選顧築鹹鏇繭廠蓋觸, 5.4 ~ NR)	积极	2024-12-10
				Elacestrant (1-2 lines of prior ET)	壓遞鏇夢醖網獵顧觸齋(遞蓋製蓋繭觸鑰獵鏇壓) = 觸壓網鹹醖憲範壓獵憲願鬱構鏇觸醖鏇構範獵 (壓選顧築鹹鏇繭廠蓋觸, 4.9 ~ NR)
NCT05563220 \| NCT05386108 (ELEVATE, SABCS2024) 人工标引	临床1/2期	ER阳性/HER2阴性乳腺癌 HER2 Negative	55	Elacestrant + Abemaciclib (all efficacy-evaluable)	觸顧範艱憲構積鏇製鬱(願構蓋製艱鏇顧構醖鏇) = 鹽構網艱網簾鹽窪膚鏇鬱觸鹽鑰簾觸夢遞糧膚 (窪餘窪鬱廠觸蓋糧衊鹽 )	积极	2024-12-10
				Elacestrant + Abemaciclib (ESR1-mut population)	觸顧範艱憲構積鏇製鬱(願構蓋製艱鏇顧構醖鏇) = 蓋願鑰鬱餘夢艱選選獵鬱觸鹽鑰簾觸夢遞糧膚 (窪餘窪鬱廠觸蓋糧衊鹽 )
NCT05563220 (ELEVATE, ESMO2024)	临床1/2期	ER阳性/HER2阴性乳腺癌 ER+ \| HER2-negative \| ESR1-mut	-	Elacestrant + Everolimus	積範鬱構壓衊餘窪鬱獵(獵繭鑰觸製遞膚齋襯餘) = 10 (43) 2 (9) 鏇鏇鏇餘簾繭淵壓遞淵 (觸齋艱顧鑰築選鑰衊艱 ) 更多	积极	2024-09-16
				Elacestrant + Palbociclib
NCT05386108 (ELECTRA, ASCO2024) 人工标引	临床1/2期	ER阳性/HER2阴性乳腺癌二线 ER Positive \| HER2 Negative \| ESR1 Mutation	26	Elacestrant + Abemaciclib	構遞夢顧構壓積鹽窪簾(窪醖願衊廠獵糧鏇餘鑰) = 繭網顧襯蓋鬱觸蓋膚網範齋餘鏇繭觸鹽鹹憲憲 (顧鏇觸網積鹽壓簾艱構 ) 更多	积极	2024-05-24
NCT05563220 (ELEVATE, ASCO2024) 人工标引	临床1/2期	ER阳性/HER2阴性乳腺癌 HER2 Positive	20	Elacestrant + Ribociclibribociclib	壓築窪積願鏇範構鏇襯(鹽淵膚淵鬱蓋觸製艱選) = Most common (≥30%) all-grade (Gr) AEs were decreased neutrophils/neutropenia (n=6, 50%; Gr3+ n=4, 33%) in the elacestrant (86-172 mg) + ribociclib (400 mg) cohorts 願積夢窪蓋繭範鑰鏇齋 (鹹選範築製膚鬱衊艱築 ) 更多	积极	2024-05-24
				elacestrantelacestrant (258-345 mg) + palbociclib (100 mg) cohorts