Matthew Kurian, Assistant Professor of Medicine at the University of Kentucky College of Medicine and Physician at St. Elizabeth Healthcare, shared a post on LinkedIn:
“ASCO 2026 Preview: persevERA missed. But the real question is why?
Design: Phase III, 1L ER+/HER2 – metastatic breast cancer randomizing Giredestrant + palbociclib vs letrozole + palbociclib
Prelim Results:
- Primary endpoint (PFS) NOT met
- Numerical improvement only
Interpretation:
- Oral SERDs do not outperform AI + CDK4/6 in endocrine-sensitive 1L
- Timing + biology likely critical
Context (giredestrant program):
- evERA (post-CDK benefit)
- lidERA (early-stage signal, IDFS)
- pionERA pending, 2027 readout hopefully
Possible takeaway: Right drug, wrong setting?
What ASCO 2026 needs to answer:
- Where do oral SERDs fit?
- Which patients benefit and why did this not work if lidERA provided oral SERDS are just better endocrine therapies?
- How to combine or sequence with CDK4/6, PI3K/AKT, ADCs“
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