Giredestrant Reduces Recurrence Risk More Than Tamoxifen, Aromatase Inhibitors - lidERA Trial
Is/was anyone on the 'lidERA' Trial? Apparently there is evidence that Giredestrant may Reduce Recurrence Risk up to 30% More Than Tamoxifen, Aromatase Inhibitors. https://www.breastcancer.org/research-news/giredestrant-reduces-recurrence-risk-better-than-tamoxfen-and-aromatase-inhibitors Giredestrant Reduces Recurrence Risk More Than Tamoxifen, Aromatase Inhibitors Results from the lidERA trial suggest that giredestrant could be a new standard of care for early-stage hormone receptor-positive breast cancer. Written by Jamie DePolo | Reviewed by Kevin Fox, MD Published on December 21, 2025 In this article Taking giredestrant after surgery to remove early-stage hormone receptor-positive HER2-negative breast cancer seems to lower the risk of the cancer coming back (called recurrence) more than taking tamoxifen or an aromatase inhibitor. Giredestrant is a new oral selective estrogen receptor downregulator (SERD), a type of hormonal therapy. The research was presented at the 2025 San Antonio Breast Cancer Symposium. Key takeaways People who took giredestrant were 30% less like to have any type of recurrence — cancer coming back in the breast area or in any part of the body — than people who took tamoxifen or one of the aromatase inhibitors: Arimidex (chemical name: anastrozole), Aromasin (chemical name: exemestane), or Femara (chemical name: letrozole). People who took giredestrant were 31% less likely to have distant or metastatic recurrence — cancer coming back in a part of the body away from the breast — than people who took tamoxifen or an aromatase inhibitor. The side effects of giredestrant were similar to those of tamoxifen and the aromatase inhibitors – hot flashes and joint and muscle pain – but they appeared to be less severe. About 5% of people taking giredestrant stopped treatment because of side effects compared to about 8% of people taking an aromatase inhibitor or tamoxifen. What the results mean for you Longer follow-up of the study is needed, but if the results are confirmed, the findings could mean the first major change in treatment after surgery for early-stage hormone receptor-positive breast cancer in more than 25 years. While giredestrant isn’t yet approved by the U.S. Food and Drug Administration (FDA), Genentech, the company that makes it, is expected to apply for approval very soon. Why do the study? After surgery, many people diagnosed with early-stage hormone receptor-positive HER2-negative breast cancer take hormonal therapy, usually tamoxifen or an aromatase inhibitor, for five to 10 years to lower the risk of recurrence. Although survival rates are high with this treatment, up to 33% of people have the cancer come back. Research also shows that many people struggle with the side effects of tamoxifen and the aromatase inhibitors; studies suggest that up to 50% of people either don’t start their prescribed medicine or stop taking it early. “In early [estrogen receptor]-positive breast cancer, challenges with disease recurrence and treatment adherence mean there is an urgent need for more effective, tolerable endocrine therapies,” Aditya Bardia, MD, MPH, professor of medicine at the David Geffen School of Medicine at UCLA, said during a media briefing on the results. Bardia is also director of translational research integration at the UCLA Health Jonsson Comprehensive Cancer Center. Bardia and his colleagues studied whether giredestrant could be a better option than currently used hormonal therapies. About the study The lidERA study included 4,170 people diagnosed with stage I to stage III hormone receptor-positive HER2-negative node-positive breast cancer. Half the people were older than 54 and half were younger. About 60% were post-menopausal. After surgery, the people were randomly assigned to one of two treatments for five years: 2,084 people took giredestrant 2,086 people took tamoxifen or one of the aromatase inhibitors, whichever their doctor recommended; if people had unacceptable side effects, they could switch to a different aromatase inhibitor Detailed results Three years after completing the five years of treatment, 92.4% of the people who took giredestrant were alive with no recurrence compared to 89.6% of people who took tamoxifen or an aromatase inhibitor. This difference was statistically significant, which means that it was likely due to the difference in treatments and not just because of chance. This benefit was consistent regardless of menopausal status, cancer stage, and whether or not a person had received chemotherapy before surgery. Information on overall survival — how long people live whether or not the cancer comes back — wasn’t ready to be analyzed. But Bardia said there was a trend for better survival with giredestrant. The most common treatment-related side effects in both treatment groups were mild and included joint pain, hot flashes, and headache. Less than 2% of the people in either treatment group had serious side effects, such as high blood pressure and joint pain. Bradycardia, or a slow heart rate, is a known side effect of oral SERDs. About 11% of people who took giredestrant had bradycardia compared to about 3% of people who took tamoxifen or an aromatase inhibitor. But most of these cases were grade 1, caused no symptoms, and didn’t require people to pause or stop treatment. “The frequency of side effects were similar, including the frequency of [joint pain], with giredestrant and the standard of care endocrine therapy,” Bardia said during an episode of The Breastcancer.org Podcast, “but treatment discontinuation because of [joint pain] was lower with giredestrant compared to the standard of care endocrine therapy.” References Bardia A., et al. Giredestrant vs standard-of-care endocrine therapy as adjuvant treatment for patients with estrogen receptor-positive, HER2-negative early breast cancer: Results from the global Phase III lidERA Breast Cancer trial. SABCS 2025, Abstract GS1-10.💡 Curious about how AI is helping predict breast cancer risk?
If you’ve ever wondered what all this “AI” talk is about (and whether it’s more than just robots and buzzwords!), there’s an upcoming session you might enjoy. The VCCC Alliance is hosting an online event all about how AI is being used to improve breast cancer risk prediction. It’s designed for everyday people, no tech background needed, no fancy jargon required. Just bring your natural curiosity and perhaps a comfy chair and a cuppa. ☕ Tune in: 🗓 30 Mar 2026, 1.00–2.00pm AEDT 📍Online, register here🌸 Behind the screen with BreastScreen Victoria🌸
BreastScreen Victoria has recently shared several updates highlighting current awareness work across the breast cancer screening sector including: ✨ Launching Behind the Screen, a six‑part podcast offering a closer look at breast screening and the people behind the program. ✨A new permanent clinic also opened in Caroline Springs, improving local access to screening. ✨ They are also continuing the AI image‑reading trial, now active across one clinic in each of the state’s eight regions. Over 7,500 clients have taken part so far, with a statewide rollout planned by June 2026. BreastScreen Victoria will also appear at the Melbourne International Flower & Garden Show from 25–29 March, offering attendees the chance to learn more about breast health and book screening appointments. Thank you to BreastScreen for helping increase impact of awareness for breast cancer ❤️AI Breast Cancer Risk Tool Back in the Spotlight 🧠
A topic that's come up in our Online Network in recent times is making headlines again - the use of artificial intelligence (AI) to better predict breast cancer risk. ABC News has reported on the new Australian research showing that an AI tool called 'BRAIx' can identify women at high likelihood of developing breast cancer even when their mammograms show no signs of cancer. Read more via the link Artificial intelligence detects high breast cancer risk in women given all-clear According to the study, 1 in 10 women who fell in the top 2% of risk scores did go on to develop breast cancer, despite having been given the “all clear” at screening. The team behind the project says the tool could be ready for wider use within about five years, potentially opening the door to more personalised screening rather than the current one‑size‑fits‑all approach.
Policy & Advocacy Update - Vicki Durston - Feb26
As we continue to move through 2026, there’s a real sense of progress building across breast cancer outcomes - both here at home and internationally. I want to share two important moments that highlight how evidence, leadership, and advocacy are shaping a better future for those affected by breast cancer. ✨ Why AI in mammography can’t wait Eric Topol’s recent article, “Why All Mammograms Should Incorporate AI,” brings together powerful evidence showing that AI in breast screening is no longer a future idea - it’s part of modern, effective care today. One of the strongest examples is the large MASAI trial from Sweden, involving more than 105,000 women. When radiologists used AI as support, the outcomes were remarkable: 👉 29% more cancers detected 👉 24% more invasive cancers found 👉 No increase in false positives or recalls 👉 44% reduction in radiologist workload Two-year follow-up findings were equally compelling: fewer interval cancers, fewer invasive cancers, and fewer aggressive types such as triple negative and HER2-positive cancers. What international evidence now shows International evidence is telling a very consistent story. Large trials and real-world evaluations show that AI-supported mammography can safely increase cancer detection while reducing radiologist workload, without increasing false positives or unnecessary recalls. This matters in a system already under pressure. AI is also changing how we think about risk. New image-based risk models can analyse a mammogram that appears “normal” to the human eye and still identify women at higher risk of developing breast cancer in the next few years. This opens the door to more personalised, risk-stratified screening, rather than the one-size-fits-all model we rely on today. Here in Australia, BreastScreen is a highly respected program, but it was designed more than 30 years ago. While Victoria and NSW are now piloting AI within their services, we still lack a coordinated national approach for integrating AI into breast screening that reflects today’s evidence. What BCNA is calling for We are now at a decision point. The question Eric Topol poses - “If not now, then when?”- is the same challenge facing Australia. For BCNA, this is not about chasing technology for its own sake. We are calling for AI to be treated as a core part of the evolution of breast screening, not an optional add-on. That means: Embedding AI research, evaluation and implementation within BreastScreen Ongoing, in-program national investment in screening research and quality improvement Ensuring that the benefits of new technology are delivered equitably, so no woman is left behind because of where she lives or her background If we get this right, AI won’t replace the program Australians trust - it will strengthen it, helping detect cancers earlier, supporting an overstretched workforce, and moving us closer to truly personalised, risk-stratified screening.
Help i feel like a robot
Been on exmestane and goserelin for 3 years and 4 years respectively. Is it normal to feel emotionless? I miss (?) the emotional highs and lows of having hormones. I do feel anger and frustration and at times stressed but joy, passion, deep love seem to have left me for apathy. Since I wasnt menopausal at diagnosis i have no reference pount to understand if this is normal for menopause or is it just the drugs? I kind of feel a bit jipped. Is this what the rest of my life looks like. Sorry to be dramatic but whats the point of it all?Maybe try Starting AIs slowly 'over time' to see if the side effects aren't as savage?
I am now 71 and have been on AIs for 6 years, with varying side effects (specially on Letrozole when I first started.) I will completely stop taking them next year - but in the mean time, I am slowly 'weaning myself' off them just now .... (hehe, to be totally honest, I forget to take them most of the time! LOL) My theory is that if they started us off with one tablet a week for a month, then 2, then 3 (every other day), slowly getting up to 1 x daily - that the body should adjust to it better! I believe there could be merit in giving this a go. We really need to 'trial' this in a controlled way! MANY women stop taking them altogether (often without advising their Oncs) but then, if they get a recurrence, they'd have the 'What Ifs' and possibly never forgive themselves. It doesn't really matter WHICH AI you start off with - the body will still take a BIG HIT when you suddenly start taking them daily ..... (tho there ARE some lucky ladies who barely have ANY side effects ....) I was not one of them. I lasted 6 weeks on Letrozole, then lasted 6 months on Exemestane - and then went on to Anastrozole for the last 5 years which worked the best for me (with MUCH less aches & pains.) Yet others may START on Anastrozole & hate it as much as I hated Letrozole!! SO ....... IF you are having nasty side effects and it IS affecting your quality of life adversely - speak to your Onc about it. You DON'T have to put up with it, Have a break for a few months. Try a different one, like I did. It could make ALL THE DIFFERENCE. Also consider asking your Onc about Medicinal Cannabis Oil - I've been taking it for nearly 5 years now - and it HAS made a difference! There are many online Drs who will prescribe it, if your Onc won't. SO .... If you are about to start out on AIs any time soon - maybe mention 'starting them slowly' to your Onc ..... to see if your body tolerates them better, as in the long term, the longer you are on them, the better it is to reduce the chance of recurrence xx take care & best wishesA new clinical Trial in Australia - Ember-4 (Endocrine/AI alternative) - has anyone heard of it?
EMBER-4: A Randomized, Open-Label, Phase 3 Study of Adjuvant Imlunestrant vs Standard Adjuvant Endocrine Therapy in Patients who have previously Received 2 to 5 years of Adjuvant Endocrine Therapy for ER+, HER2- Early Breast Cancer with an Increased Risk of Recurrence (These links show other BC Trials that are currently 'open' in Australia - but only the WA page mentions Ember-4 ... ) https://www.breastcancertrials.org.au/research/open-clinical-trials/ https://bcrc-wa.com.au/open-clinical-trials/ https://trials.cancervic.org.au/search/ (Put Breast Cancer in the search area) https://www.australianclinicaltrials.gov.au/anzctr-search-results?search_text=breast%2Bcancer&condition_category=all&condition_code=all&recruitment_status=Recruitingðics_approval=Yes Not sure if this will help anyone - it is a different form of AI they are 'testing' ... I found this info on the Ember-4 trial on one of the Facebook BC sites ..... (BTW, this is NOT written by me and does not relate to me in any way .. ) (SERDs are an important endocrine therapy used to treat ER-positive breast cancer. Parenteral SERD Fulvestrant has been approved and used in the treatment of metastatic ER-positive breast cancer for the last 2 decades.) From a Facebook BC Post: Is anyone else on the Ember-4 trial? I found out yesterday that I was selected in the trial to get Ilumestrant (a new SERD that replaces your AI) so that is quite exciting, but I ended up with horrible diarrhoea yesterday after taking my first dose, so hopefully that is not a side-effect that continues… Ilumestrant is a Selective Estrogen Receptor Degrader (SERD) that you take instead of taking an oestrogen blocker or aromatase inhibitor… it degrades the estrogen receptor sites in the cancer cells rather than blocking your oestrogen, so it allows your body to have some oestrogen and hopefully less joint aches and pains etc… An interesting thing about it is that you must fast for one hour before you take it, and for two hours after you take it. This will not be an issue for me, but I imagine it could be hard in some situations.Angela Brodie - the story of the lady who 'invented' Aromatase Inhibitors!
Before Aromatase Inhibitors were made available to women to suppress oestrogen production that fed their Breast Cancer ..... the most common procedure for women with breast cancer was Radical Mastectomies. Angela Brodie was a giant in the world of breast-cancer therapy. She discovered and developed the first selective aromatase inhibitor — a drug that blocks the synthesis of oestrogen, which fuels the growth of breast-cancer cells. Such treatments have saved the lives of hundreds of thousands of women; a third generation of the compounds are now the drugs of choice in postmenopausal women. Angela was determined to change that - and change it, she did! An interesting read: https://www.nature.com/articles/548032aMagnesium to help combat 'brain fog' on Tamoxifen/AIs? NZ trial suggests YES
Are you experiencing cognitive issues (even if you haven't had chemo but are on AIs - brain fog?) A trial in NZ is looking at using magnesium to mitigate those memory and concentration issues particularly for women on Tamoxifen. They suggest it should help with other AIs too. https://www.breastcancerfoundation.org.nz/news-articles/article/memory-and-concentration-problems-on-tamoxifen-sound-familiar-/57
