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Fulvestrant + pembrolizumab is an investigational combination therapy for hormone receptor-positive, HER2-negative advanced or metastatic breast cancer. Fulvestrant is a selective estrogen receptor degrader (SERD) that binds to and accelerates the degradation of the estrogen receptor, thereby blocking estrogen signaling critical for tumor growth in ER-positive cancers. Pembrolizumab is a monoclonal antibody immune checkpoint inhibitor targeting programmed cell death protein 1 (PD-1), which enhances T-cell mediated anti-tumor immunity by preventing PD-1 from binding its ligands PD-L1 and PD-L2 on tumor cells. The rationale for combining these agents is to leverage endocrine therapy’s effect on hormone-driven tumors with immunotherapy’s ability to stimulate immune responses against cancer cells. This combination has shown manageable toxicity and disease control in phase II studies in patients with ER+/HER2- metastatic breast cancer who have received prior lines of endocrine or chemotherapy[1][3][4].
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