Fulvestrant for the treatment of advanced breast cancer

Expert Rev Anticancer Ther. 2018 Jul;18(7):619-628. doi: 10.1080/14737140.2018.1473038. Epub 2018 May 15.


The current issues with endocrine therapy for treatment of advanced breast cancer include balance of efficacy of therapy versus tolerability as well as hormone resistance. The efficacy of fulvestrant, a selective oestrogen receptor degrader (SERD), has been demonstrated in hormone receptor positive patients previously untreated or treated with hormonal therapy. Areas covered: This article discusses the journey of fulvestrant licensing, its efficacy in combination with other endocrine therapies and the future role it may have within breast cancer treatment. Expert commentary: Within phase III trials, fulvestrant has demonstrated equivalent or improved clinical efficacy when compared with established endocrine agents. In the recent decade, fulvestrant has achieved licensing as a second line agent in non-operative advanced breast cancer at initially 250mg, increasing to 500mg. Presently, fulvestrant is licensed globally as first line endocrine management for advanced breast cancer in post-menopausal women. Early combination trials of fulvestrant and cyclin dependent kinase 4/6 inhibitors have demonstrated good clinical efficacy with improved progression free survival when compared to fulvestrant alone.

Keywords: Fulvestrant; advanced breast cancer; endocrine therapy; pure anti-oestrogen.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Antineoplastic Agents, Hormonal / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Disease-Free Survival
  • Estrogen Receptor Antagonists / administration & dosage
  • Female
  • Fulvestrant / administration & dosage*
  • Humans
  • Postmenopause


  • Antineoplastic Agents, Hormonal
  • Estrogen Receptor Antagonists
  • Fulvestrant