Internal medicine

Estrogen receptor alpha

Cancer

Chemistry

Estrogen

Selective estrogen receptor modulator

Aromatase

Fulvestrant

Breast cancer

Estrogen receptor beta

Endocrine system

Cancer research

Hormone

Medicine

Estrogen receptor

Pharmacology

Journal of Medicinal Chemistry

Estrogen receptor (ER) plays important roles in gene transcription and the proliferation of ER positive breast cancers. Selective modulation of ER has been a therapeutic target for this specific type of breast cancer for more than 30 years. Selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs) have been demonstrated to be effective therapeutic approaches for ER positive breast cancers. Unfortunately, 30–50% of ER positive tumors become resistant to SERM/AI treatment after 3–5 years. Fulvestrant, the only approved selective estrogen receptor degrader (SERD), is currently an important therapeutic approach for the treatment of endocrine-resistant breast cancers. The poor pharmacokinetic properties of fulvestrant have inspired the development of a new generation of oral SERDs to overcome drug resistance. In this review, we describe recent advances in ERα structure, functions, and mechanisms of endocrine resistance and summarize the development of oral SERDs in both academic and industrial areas.

Selective Estrogen Receptor Degraders (SERDs): A Promising Strategy for Estrogen Receptor Positive Endocrine-Resistant Breast Cancer