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Translational Medicine / 转化医学ESR1 Mutations, Elacestrant & SERENA-6

Fabrice André

法布里斯·安德烈

MD, PhD

🏢Gustave Roussy Cancer Campus(古斯塔夫·鲁西癌症中心)🌐France

Professor and Head, Department of Medical Oncology, Gustave Roussy; Director of Research, Gustave Roussy古斯塔夫·鲁西医学肿瘤学系主任、教授;古斯塔夫·鲁西研究主任

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Key Papers
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Awards
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Key Contributions

👥Biography 个人简介

Fabrice André, MD, PhD is Professor and Head of the Department of Medical Oncology at Gustave Roussy Cancer Campus in Paris, France, where he also serves as Director of Research. He is one of Europe's most prominent translational oncologists and has defined the molecular landscape of endocrine resistance in HR+ breast cancer. Dr. André's most influential contribution has been the characterization of ESR1 ligand-binding domain mutations as the dominant mechanism of acquired resistance to aromatase inhibitor therapy, establishing liquid biopsy detection of ESR1 mutations as both a clinical biomarker and a therapeutic target. He led pivotal preclinical and early clinical work supporting the development of oral selective estrogen receptor degraders (SERDs), and is the global principal investigator of the SERENA-6 trial, a landmark ctDNA-guided adaptive trial in which patients detected to have ESR1 mutations on liquid biopsy are randomized to switch to camizestrant (an oral SERD) or continue standard therapy. Dr. André also spearheaded the SAFIR02_BREAST trial, demonstrating the feasibility of genomic-guided treatment allocation in metastatic breast cancer. He is past editor-in-chief of Annals of Oncology and a founding contributor to the European ESMO Translational Research and Precision Medicine Working Group. He has published more than 400 peer-reviewed articles and is among the most cited scientists in breast cancer translational research globally.

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🧪Research Fields 研究领域

ESR1 Mutations and Endocrine Resistance in Breast Cancer乳腺癌ESR1突变与内分泌耐药
Elacestrant and Selective Estrogen Receptor Degraders (SERDs)艾拉司坦与选择性雌激素受体降解剂(SERD)
SERENA-6 Trial and ctDNA-Guided TherapySERENA-6试验与ctDNA引导治疗
CDK4/6 Inhibitor Resistance GenomicsCDK4/6抑制剂耐药基因组学
Genomic Sequencing and Precision Oncology in Breast Cancer乳腺癌基因组测序与精准肿瘤学

🎓Key Contributions 主要贡献

ESR1 Mutations as Mechanism of Aromatase Inhibitor Resistance

Characterized ESR1 ligand-binding domain mutations as the primary acquired resistance mechanism to aromatase inhibitor therapy in HR+ metastatic breast cancer, demonstrating their emergence in ctDNA during treatment and their association with inferior outcomes on subsequent endocrine therapy, fundamentally reshaping resistance biology understanding in the field.

SERENA-6 — ctDNA-Guided Adaptive Therapy in HR+ Breast Cancer

Designed and leads the SERENA-6 adaptive trial, in which ctDNA-detected ESR1 mutations during first-line CDK4/6 inhibitor plus aromatase inhibitor therapy trigger randomization to switch to the oral SERD camizestrant, testing whether proactive biomarker-guided treatment adaptation can delay clinical progression and improve outcomes.

Oral SERD Development and Clinical Translation

Led foundational translational studies validating oral SERDs—including elacestrant and camizestrant—as therapeutically superior to fulvestrant in ESR1-mutant HR+ breast cancer models, enabling registration-directed trials. Contributed to the EMERALD trial of elacestrant that led to FDA approval in ESR1-mutant disease.

SAFIR02 — Genomic-Guided Treatment Allocation in Metastatic Breast Cancer

Designed and led SAFIR02_BREAST, one of the first prospective randomized trials to test genomic-guided targeted therapy versus maintenance chemotherapy in metastatic breast cancer, demonstrating feasibility and benefit in BRCA1/2-mutated and FGFR-amplified subgroups and informing the design of next-generation basket and umbrella trials.

Representative Works 代表性著作

[1]

ESR1 mutations as a mechanism of acquired resistance to aromatase inhibitor therapy in hormone receptor-positive breast cancer

Nature Genetics (2013)

Landmark study identifying ESR1 LBD mutations as the dominant mechanism of acquired aromatase inhibitor resistance, providing rationale for SERD-based strategies and liquid biopsy monitoring in HR+ metastatic breast cancer.

[2]

Elacestrant versus standard endocrine therapy in patients with ESR1-mutated, ER+/HER2- metastatic breast cancer (EMERALD)

Journal of Clinical Oncology (2023)

EMERALD phase III trial demonstrating that elacestrant significantly improved PFS over fulvestrant or aromatase inhibitors in ESR1-mutant HR+/HER2- metastatic breast cancer, leading to FDA approval.

[3]

Genomic characterization of metastatic breast cancers

Nature (2019)

Large-scale whole-genome sequencing of metastatic breast cancer revealing mutational landscape, driver alterations, and actionable targets across subtypes, establishing a foundation for precision oncology in advanced disease.

[4]

Targeting FGFR1-amplified breast cancer with the selective pan-FGFR kinase inhibitor dovitinib

Cancer Discovery (2013)

Identified FGFR1 amplification as a driver and therapeutic target in HR+ breast cancer, providing preclinical and early clinical evidence for FGFR-directed therapy in endocrine-resistant disease.

🏆Awards & Recognition 奖项与荣誉

🏆Annals of Oncology Past Editor-in-Chief
🏆ESMO Translational Research Award
🏆Institut National du Cancer (INCa) Excellence Award
🏆European Research Council (ERC) Advanced Grant

📄Data Sources 数据来源

Last updated: 2026-04-06 | All information from publicly available academic sources

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