What is the recommended dose and usage of camizestrant (SERD - Selective Estrogen Receptor Degrader) in patients?

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Recommended Dosage and Usage of Camizestrant in Patients

The recommended dose of camizestrant for patients with estrogen receptor-positive, HER2-negative advanced breast cancer is 75 mg orally once daily, which has demonstrated significant improvement in progression-free survival compared to fulvestrant with a favorable safety profile. 1

Dosage and Administration

  • Camizestrant is administered as an oral tablet at a dose of 75 mg once daily 1, 2
  • The 75 mg dose is considered the optimal dose for phase III clinical development based on efficacy and safety data from phase I and II trials 2
  • Pharmacokinetic studies show that camizestrant reaches maximum concentration approximately 2-4 hours post-dose with an estimated half-life of 20-23 hours, supporting once-daily dosing 2

Clinical Indications

  • Camizestrant is indicated for patients with estrogen receptor-positive (ER+), HER2-negative advanced breast cancer 1
  • It has shown particular efficacy in patients with:
    • Prior treatment with CDK4/6 inhibitors 2
    • Prior treatment with fulvestrant 2
    • Presence of ESR1 mutations 3
    • Visceral disease, including liver metastases 2

Efficacy Data

  • In the SERENA-2 trial, camizestrant 75 mg demonstrated superior progression-free survival compared to fulvestrant (7.2 months vs 3.7 months; HR 0.59; p=0.017) 1
  • The SERENA-6 trial showed that switching to camizestrant 75 mg in patients who developed ESR1 mutations during first-line therapy with an aromatase inhibitor plus CDK4/6 inhibitor significantly improved progression-free survival (16.0 months vs 9.2 months; HR 0.44; p<0.0001) 3

Combination Therapy

  • Camizestrant 75 mg can be safely combined with CDK4/6 inhibitors (abemaciclib, palbociclib, or ribociclib) with no clinically meaningful drug-drug interactions 4
  • When used in combination with CDK4/6 inhibitors in heavily pretreated patients, the clinical benefit rate at 24 weeks was 49.5% with a median progression-free survival of 7.4 months 4

Safety Profile

  • Most common treatment-related adverse events with camizestrant 75 mg include:
    • Visual effects (56%) 2
    • Sinus bradycardia (44%) 2
    • Fatigue (26%) 2
    • Nausea (15%) 2
  • The majority of adverse events (82.4%) are grade 1 or 2 2
  • No grade 3 or higher treatment-related adverse events or serious adverse events were reported at doses ≤150 mg 2
  • Discontinuation rate due to adverse events is low (1.3%) 3

Monitoring and Follow-up

  • Regular assessment of disease response using RECIST 1.1 criteria is recommended 1
  • Monitoring for common adverse events, particularly visual effects and bradycardia, is advised 2
  • Quality of life assessments should be performed, as camizestrant has shown delayed time to deterioration in global health status compared to aromatase inhibitors (21.0 months vs 6.4 months) 3

Future Directions

  • Camizestrant is currently being investigated in the early breast cancer setting in the CAMBRIA-1 and CAMBRIA-2 phase III trials 5
  • These trials are evaluating camizestrant versus standard endocrine therapy in patients with ER+/HER2- early breast cancer at intermediate to high risk of recurrence 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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