SERENA-6 interpretation and clinical implications: intercepting endocrine resistance in metastatic breast cancer

Q: What does this research mean for the field?

Integrating emerging ctDNA targets to guide early treatment switches, such as changing to camizestrant upon ESR1 mutation detection before disease progression, is a valid and beneficial adaptive strategy in metastatic breast cancer. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

F C Bidard; Carlos Barrios; Giampaolo Bianchini; A Brufsky; Stephen Chia; J Cortés; M Cristofanilli; G Curigliano; Shaheenah Dawood; P A Fasching; Lorenzo Gerratana; A G Giordano; M Ignatiadis; H Iwata; Wolfgang Janni; E Lim; Kevin Kalinsky; C X Ma; Erica L. Mayer; Arielle J. Medford; Jason A. Mouabbi; Joyce O’Shaughnessy; Yeon Hee Park; J Pascual; Pedram Razavi; Sarah Sammons; José Luis Sandoval; L. Sisca; Paolo Tarantino; Seth A. Wander; Gustavo Werutsky; Nicholas Turner

doi:10.1038/s41523-026-00967-4

Key Points

This research aims to clarify the implications of switching to camizestrant upon detecting ESR1 mutations in metastatic breast cancer patients.
Patients received first-line aromatase inhibitors plus CDK4/6 inhibitors.
Switching to camizestrant was initiated upon detection of ESR1 mutations.
Integration of ctDNA targets was discussed for future treatment decisions.
Evidence supports the adaptive oncology approach with camizestrant leading to improved outcomes.
The timing of the switch upon mutation detection is crucial for managing resistance.
Questions remain about the role of ctDNA targets in guiding treatment decisions.

Implication

Shows benefits of switching treatment in female patients, suggesting a new approach to manage resistance.

Abstract

In patients treated with first-line AI plus CDK4/6 inhibitor, SERENA-6 showed the benefit of switching from an aromatase inhibitor to the oral SERD camizestrant upon detection of an emerging ESR1 mutation, before disease progression. While this adaptive oncology approach has shown key benefits for patients, the integration of emerging ctDNA targets into treatment decisions has been questioned. Here, we provide further clarification on several aspects of this clinically relevant discussion.

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Cite This Study

Bidard et al. (2026) studied this question.

synapsesocial.com/papers/6a29012e6f82f25be989d8cf https://doi.org/10.1038/s41523-026-00967-4

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SERENA-6 interpretation and clinical implications: intercepting endocrine resistance in metastatic breast cancer

Key Points

Implication

Abstract

Discussion

Cite This Study

SERENA-6 interpretation and clinical implications: intercepting endocrine resistance in metastatic breast cancer

Key Points

Implication

Abstract

Discussion

Cite This Study

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