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Case Challenge: ESR1 mBC

CE / CME

Case Challenge: HR+/HER2- mBC Treatment Following Progression on Endocrine Therapy and CDK4/6 Inhibitor

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Pharmacists: 0.50 contact hour (0.05 CEUs)

ABIM MOC: maximum of 0.50 Medical Knowledge MOC point

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

Nurse Practitioners/Nurses: 0.50 Nursing contact hour

Released: February 18, 2026

Expiration: August 17, 2026

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

A 67-year-old woman with de novo HR-positive/HER2-negative metastatic breast cancer previously treated with ribociclib plus letrozole now presents with progression in her bones after 3 years of disease control. Circulating tumor DNA (ctDNA) testing at progression reveals an ESR1 D538G mutation without PIK3CA/AKT/PTEN alterations or germline BRCA1/2 mutations.

At this time, which of the following are FDA-approved options for this patient?

2.

A 68-year-old woman expresses anxiety about nausea before starting elacestrant and says she “loses confidence” when symptoms appear. Which counseling approach best reduces nausea and strengthens her ability to stay adherent?