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The use of Orserdu for breast cancer




Approximately 685,000 out of 10 million cancer-related deaths will be due to breast cancer (Turner, 2023). This only goes to demonstrate the increasing need to find a solution to resolving the growth and deterioration of current breast cancer patients’s conditions, and it has been an arduous journey. The biological mechanisms of cancer cells makes it almost impossible to find a one-size-fits-all cure, however recent advancements in the pharmacological industry have brought about a new drug making waves. The drug, Orsedu, will be used to help manage advanced metastatic breast cancer, and this article will delve deeper into the usage of the drug, its side effects, and future applications of the drug in other pharmaceutical opportunities. 


Principles of Breast Cancer 

Breast cancer, just like any other type of cancer, is extremely difficult to cure fully due to its very evolving nature. Breast cancer occurs when some breast cells begin to grow abnormally, dividing more rapidly than healthy cells and accumulating to form a lump or mass. These abnormal cells have the potential to grow out of control and invade the surrounding tissue, leading to invasive breast cancer. The exact causes of these abnormal cell growths are not fully understood, but they are believed to involve a complex interaction of genetic makeup, hormonal, lifestyle, and environmental factors. The development and progression of breast cancer involve a range of factors, including cancer stem cells, signaling pathways, genomics, and molecular pathogenesis. The risk factors associated with breast cancer are diverse, and the disease is biologically and molecularly heterogeneous. (NBCF, n.d)

Orsedu targets metastatic advanced-stage breast cancer, and this means that the cancer has spread to parts of the body away from the breast, such as the bones (DePolo, 2023), making it even more difficult to find targeted drugs or medicine to help reduce the impact of cancer on the cellular system. Metastatic breast cancer often arises as a result of an ESR1 gene mutation, as this controls the structure of estrogen receptors, and might cause it to become resistant to hormone therapy (Turner, 2023). 


Orserdu’s Functions and Usages in the Treatment of Breast Cancer

Orsedu is a selective estrogen receptor degrader (SERD), specifically intended for individuals with estrogen receptor-positive human epidermal growth factor receptor 2- negative breast cancer, characterized by ESR1 mutations (DePolo, 2023). It is used after the patient has taken at least one hormonal therapy medicine and can be taken orally, as a pill. By adhering to the estrogen receptors on the cells, Orserdu inhibits the effects of estrogen on hormone receptor-positive breast cancer cells. Orserdu in the receptor prevents estrogen from attaching to the cancer cell, preventing the cell from receiving signals from estrogen to proliferate. Moreover, orserdu alters the structure of estrogen receptors, impairing their functionality which prevents the mutation of the ESR1 gene, highly reducing the probability of cancer cells metastasizing away from the breast to other parts of the body (Puckey, 2023). There was a clinical trial carried out that demonstrated 478 patients with ER-positive, HER2-negative breast cancer that had begun to spread and whose disease had returned or had not responded to at least one prior treatment were included in the major trial that examined Orserdu. The results of the trial demonstrated that patients treated with Orserdu, whose cancer cells possessed an ESR1 mutation, lived an average of 3.8 months without experiencing a worsening of their condition, in contrast to 1.9 months for patients receiving standard therapy (European Medicines Agency, 2023). 


Challenges and future directions:

However, as with all drugs, there are side effects from the usage of the drug. With Orsedu, these are muscle/joint pain, tiredness, headache, flushing, diarrhea, constipation, upset stomach, heartburn, nausea, vomiting, or decreased appetite may occur (WebMd, 2023). These were found in more than 10% of the consumers. While this is an incredible breakthrough in the pharmacological industry regarding breast cancer, there is still much research to be conducted regarding other types of cancer as well. Currently the drug, Olaparib targets cancers with mutations in the BRCA genes and works by stopping cancer cells from being able to repair their DNA by blocking a molecule called PARP, which causes the cancerous cells to die. This is set to be used for advanced prostate cancer, and HER2-negative early breast cancer (NHS, 2023). 


Clinical trials have demonstrated that olaparib, taken as a tablet daily, can extend patients' lives by an average of six months, from 12 to 18 months, in cases with advanced prostate cancer that has progressed to another part of the body. This means that patients can spend more time with friends and family. Giving olaparib after chemotherapy decreased the relative risk of the disease returning within four years by nearly a third, according to clinical trials in BRCA-mutant, HER2-negative early breast cancer (OlympiA) (invasive disease-free survival at four years was 82.7% in the olaparib arm, compared to 75.4% in the placebo arm) (NHS, 2023). 

 

Article prepared by: Yuen Yeng Cheong, R&D Associate of MBIOS 2023/2024


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References


  1. DePolo, J. (2023, December 15). Orserdu (Elacestrant): How It Works, Interactions and Side Effects. Breastcancer.org. Retrieved January 25, 2024, from https://www.breastcancer.org/treatment/hormonal-therapy/orserdu 

  2. European Medicines Agency. (2023, November 27). Orserdu | European Medicines Agency. European Medicines Agency. Retrieved January 25, 2024, from https://www.ema.europa.eu/en/medicines/human/EPAR/orserdu 

  3. National Breast Cancer Foundation. (2023). How Does Breast Cancer Start & Spread? | Breast Cancer Anatomy | NBCF. National Breast Cancer Foundation. Retrieved January 25, 2024, from https://nbcf.org.au/about-breast-cancer/diagnosis/breast-cancer-anatomy/ 

  4. NHS England. (2023, April 6). NHS strikes landmark deal for drug to treat two most common cancers. NHS England. Retrieved January 25, 2024, from https://www.england.nhs.uk/2023/04/nhs-strikes-landmark-deal-for-drug-to-treat-two-most-common-cancers/ 

  5. Puckey, M. (2023, August 23). Orserdu: Uses, Side Effects, Dosage, Warnings. Drugs.com. Retrieved January 25, 2024, from https://www.drugs.com/orserdu.html 

  6. Turner, S. (2023, November 9). Pharma breakthroughs: 10 novel drug approvals that made headlines in 2023. Pharmaceutical Technology. Retrieved January 25, 2024, from https://www.pharmaceutical-technology.com/features/pharma-breakthroughs-10-novel-drug-approvals-that-made-headlines-in-2023/?cf-view&cf-closed 

  7. WebMD. (n.d.). Orserdu Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing. WebMD. Retrieved January 25, 2024, from https://www.webmd.com/drugs/2/drug-185889/orserdu-oral/details 

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