How to manage side effects of Elacestrant in HER2- MBC?

Elacestrant is an oral selective estrogen receptor degrader (SERD) used in the treatment of hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (MBC). While it can offer significant therapeutic benefits, managing the side effects is crucial for maintaining patients' quality of life. This article offers a comprehensive guide on managing these side effects effectively.

Understanding Elacestrant and Its Role in HER2- MBC

Elacestrant has emerged as a promising treatment option for patients with HER2- MBC, particularly after the failure of prior endocrine therapies. As a SERD, Elacestrant works by binding to the estrogen receptor, degrading it, and thereby inhibiting estrogen's ability to promote the growth of breast cancer cells. This medication is administered orally and has demonstrated efficacy in clinical trials, showing improved outcomes for patients compared to traditional therapies.

Common Side Effects of Elacestrant

Like many cancer therapies, Elacestrant is associated with several side effects. Commonly reported side effects include nausea, fatigue, and hot flashes. Additionally, patients may experience gastrointestinal disturbances such as vomiting, diarrhea, or constipation. Some patients may also show signs of liver function abnormalities, which necessitates regular monitoring of liver enzymes.

Managing Nausea and Vomiting

To manage nausea and vomiting associated with Elacestrant, patients are advised to eat smaller, more frequent meals rather than large portions. Incorporating ginger or peppermint tea into the diet can also help alleviate these symptoms. Furthermore, antiemetic medications may be prescribed by healthcare providers to control severe nausea or vomiting, ensuring patient comfort.

Addressing Fatigue

Fatigue is a common side effect that can significantly impact a patient's daily life. It is essential to encourage patients to maintain a balanced diet and stay hydrated. Implementing a regular yet light exercise regimen can also help combat feelings of fatigue and promote energy levels. Utilizing relaxation techniques such as yoga or meditation may further assist in managing fatigue.

Coping with Hot Flashes

Hot flashes can be distressing for many patients undergoing treatment with Elacestrant. Keeping the environment cool and wearing loose, breathable clothing can help. Several over-the-counter remedies, including certain phytoestrogens, may provide relief; however, these should be discussed with a healthcare provider before use. Acupuncture has also been reported by some patients as an effective method for reducing the frequency and intensity of hot flashes.

Monitoring Liver Function

Due to the potential for liver abnormalities, regular liver function tests are crucial for patients receiving Elacestrant. Patients should report any signs of liver dysfunction, including jaundice, dark urine, or severe abdominal pain, to their healthcare providers immediately. Depending on the results of liver tests, adjustments to the treatment regimen may be necessary.

Emotional and Psychological Support

The emotional toll of cancer treatment can be significant. Encouraging open discussions about feelings and experiences can be therapeutic for patients. Support groups and counseling services can provide additional support, allowing patients to connect with others undergoing similar journeys. Incorporating mindfulness practices may also aid in emotional well-being.