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Fulvestrant is a monthly intramuscular injection that degrades the oestrogen receptor rather than blocking it, the endocrine backbone paired with CDK4/6, PI3K and AKT inhibitors once aromatase inhibitors fail. Slow uptake and incomplete receptor degradation drove the search for oral degraders.
First selective oestrogen receptor degrader (2002). Backbone of PALOMA-3, MONARCH 2, MONALEESA-3, SOLAR-1, CAPItello-291, INAVO120, and the control arm of every oral SERD trial. Limitations: intramuscular 500 mg injections, slow steady state, and incomplete ER degradation, which motivated oral SERDs and the PROTAC vepdegestrant.
Binds ER, blocks dimerisation and nuclear localisation, accelerates proteasomal degradation. Connects to Estrogen receptor (ERα).
1.Fulvestrant acts on Estrogen receptor (ERα), the hormone receptor or the enzyme that makes the hormone.
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Intramuscular injection in the clinic (HCPCS J9395); generic fulvestrant since 2019.
Multi-source generic; covered under the medical benefit without prior authorisation in most plans, as part of standard regimens.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
Sources: NICE TA239. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
FDA approves gedatolisib with fulvestrant, with or without palbociclib, for HR-positive, HER2-negative locally advanced or metastatic breast cancer source
| Region | Year | Indication |
|---|---|---|
| US | 2002 | HR+ advanced breast cancer after antioestrogen therapy |
| US | 2017 | First-line HR+ advanced breast cancer (FALCON) |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Injection-site pain | 14% | - |
| Hot flushes | 13% | - |
| Arthralgia | 17% | - |
Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
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Query for this drug: (TITLE:"Fulvestrant" OR ABSTRACT:"Fulvestrant" OR TITLE:"Faslodex" OR ABSTRACT:"Faslodex") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Fulvestrant, not a curated reading list.
Shares SNV4818 in Participants With Advanced Solid Tumors, DNA-guided Second Line Adjuvant Therapy for High Residual Risk, Estrogen Receptor Positive, HER-2 Negative Breast Cancer (DARE), PF-07104091 as a Single Agent and in Combination Therapy, Study for Participants Continuing From Pfizer-sponsored Palbociclib (a Study Medicine) Studies.
Shares A Phase IIIB Study to Evaluate the Use of Capivasertib in Combination With Fulvestrant in Patients With Advanced Breast Cancer Who Have Relapsed/Progressed on ET and CDK4/6 Inhibitor Reflecting Real World Clinical Practice in Spain, Capivasertib+Fulvestrant asTreatment for Locally Advanced(Inoperable) or Metastatic HR+/HER2- Breast Cancer in Chinese Patients, To Study the Effect of Inavolisib in Combination With Fulvestrant in Participants With Breast Cancer, Study Assessing the Efficacy and Safety of Treatment With Alpelisib Plus Fulvestrant in Japanese Men and Postmenopausal Women With Advanced Breast Cancer.
Shares Open-Label Study to Evaluate the Safety, Tolerability, PK, and Efficacy of INX-315 in Patients With Advanced Cancer, Evaluation of Lasofoxifene Combined With Abemaciclib Compared With Fulvestrant Combined With Abemaciclib in Locally Advanced or Metastatic ER+/HER2- Breast Cancer With an ESR1 Mutation, A Study of Abemaciclib (LY2835219) in Participants With Breast Cancer, A Study of Abemaciclib (LY2835219) Combined With Fulvestrant in Women With Hormone Receptor Positive HER2 Negative Breast Cancer.
Shares Study Assessing the Efficacy and Safety of Treatment With Alpelisib Plus Fulvestrant in Japanese Men and Postmenopausal Women With Advanced Breast Cancer, Study Assessing the Efficacy and Safety of Treatment With Alpelisib Plus Fulvestrant Versus Placebo Plus Fulvestrant in Chinese Men and Postmenopausal Women With Advanced Breast Cancer, A Study Evaluating the Efficacy and Safety of Inavolisib Plus Fulvestrant Compared With Alpelisib Plus Fulvestrant in Participants With HR-Positive, HER2-Negative, PIK3CA Mutated, Locally Advanced or Metastatic Breast Cancer Post CDK4/6i and Endocrine Combination Therapy, Gedatolisib Plus Fulvestrant With or Without Palbociclib vs Standard-of-Care for the Treatment of Patients With Advanced or Metastatic HR+/HER2- Breast Cancer (VIKTORIA-1).
Shares Study of GVV858 as a Single Agent or in Combination With Endocrine Therapy in Patients With HR+/HER2- Breast Cancer and Other Advanced Solid Tumors, PF-07104091 as a Single Agent and in Combination Therapy, Study to Test the Safety and Tolerability of PF-07220060 in Participants With Advance Solid Tumors, Study of AVZO-021 in Patients With Advanced Solid Tumors.
Shares Study of ECI830 Single Agent or in Combination in Patients With Advanced HR+/HER2- Breast Cancer and in Patients With Other Advanced Solid Tumors, A Study to Evaluate Efficacy and Safety of Giredestrant Compared With Fulvestrant (Plus a CDK4/6 Inhibitor), in Participants With ER-Positive, HER2-Negative Advanced Breast Cancer Resistant to Adjuvant Endocrine Therapy (pionERA Breast Cancer), First-in-Human Study of Tersolisib (STX-478) as Monotherapy and in Combination With Other Antineoplastic Agents in Participants With Advanced Solid Tumors, Phase 3 Study of Gedatolisib as First-Line Treatment for Patients With HR-Positive, HER2-Negative Advanced Breast Cancer (VIKTORIA-2).
Shares A Study to Learn About the Study Medicine (Called PF-07220060 in Combination With PF-07104091) In Participants With Breast Cancer and Solid Tumors, Evaluation of Lasofoxifene Combined With Abemaciclib Compared With Fulvestrant Combined With Abemaciclib in Locally Advanced or Metastatic ER+/HER2- Breast Cancer With an ESR1 Mutation, Study of ECI830 Single Agent or in Combination in Patients With Advanced HR+/HER2- Breast Cancer and in Patients With Other Advanced Solid Tumors, Study for Participants Continuing From Pfizer-sponsored Palbociclib (a Study Medicine) Studies.
Shares Study of AMXT 1501 and DFMO in Combination With Standard Therapies in Advanced Solid Tumors, A Phase IIIB Study to Evaluate the Use of Capivasertib in Combination With Fulvestrant in Patients With Advanced Breast Cancer Who Have Relapsed/Progressed on ET and CDK4/6 Inhibitor Reflecting Real World Clinical Practice in Spain, Capivasertib+Fulvestrant asTreatment for Locally Advanced(Inoperable) or Metastatic HR+/HER2- Breast Cancer in Chinese Patients, Capivasertib + CDK4/6i + Fulvestrant for Advanced/Metastatic HR+/HER2- Breast Cancer (CAPItello-292).