Episode 316: Pharmacology 101: Estrogen-Targeting Therapies

“Estrogen plays a key role in promoting the proliferation of normal and breast cancer epithelium. So now we have gone from focusing just on the estrogen to also look at estrogen receptors on breast cancer cells and targeting that—and now even to a point of looking at the downstream effects of when the estrogen binds to estrogen receptor of those signaling pathways,” Rowena “Moe” Schwartz, PharmD, BCOP, FHOPA, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about estrogen-targeting anticancer therapies.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by June 14, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to estrogen-targeting therapies.

Episode Notes 

• Complete this evaluation for free NCPD. 
• Oncology Nursing Podcast episodes:
  • Pharmacology 101 series
  • Episode 242: Oncology Pharmacology 2023: Today’s Treatments and Tomorrow’s Breakthroughs
  • Episode 194: Sex Is a Component of Patient-Centered Care
  • Episode 113: Manage Cancer-Related Hot Flashes With ONS Guidelines™
• ONS Voice articles:
  • Oncology Drug Reference Sheet: Elacestrant
  • Sexual Considerations for Patients With Cancer: Evidence-Based Approaches to Confront Challenges and Offer Support
  • Oncology Drug Reference Sheet: Alpelisib
  • ONS Guidelines™ Offer Framework for Managing Treatment-Related Hot Flashes
• ONS courses:
  • Breast Cancer: Survivorship and Quality of Life
  • Breast Cancer: Treatment and Symptom Management
  • ONS/ONCC Chemotherapy Immunotherapy Certificate
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
• Clinical Journal of Oncology Nursing articles:
  • Hot Flashes: Clinical Summary of the ONS Guidelines™ for Cancer Treatment-Related Hot Flashes in Women With Breast Cancer and Men With Prostate Cancer
  • Hot Flashes: Common Side Effect
  • Treatment-Induced Ovarian Insufficiency and Early Menopause in Breast Cancer Survivors
  • Targeted Therapies: Treatment Options for Patients With Metastatic Breast Cancer
• Oncology Nursing Forum articles:
  •  Associations Between Cholecalciferol Supplementation and Self-Reported Symptoms Among Women With Metastatic Breast Cancer and Vitamin D Deficiency: A Pilot Study
  • Comparing Interventions for Management of Hot Flashes in Patients With Breast and Prostate Cancer: A Systematic Review With Meta-Analyses
• ONS Learning Libraries:
  • Breast Cancer
  • Oral Anticancer Medication
• ONS Guidelines™ and Symptom Interventions:
  • Hot Flashes
  • Oral Anticancer Medication
• ONS Huddle Cards:
  • Hormone Therapy
  • Sexuality
• Oral Chemotherapy Patient Education Sheets: Managing Hormonal Side Effects/Menopausal Symptoms

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.

Highlights From This Episode

“One of the kind of interesting things about [selective estrogen receptor degraders] is that these novel compounds also reduce the estrogen receptor alpha protein level. That becomes really important when we talk about elacestrant, because when there are mutations in the estrogen receptor protein, this is where this drug is actually indicated.” TS 7:48

“Every time I talk about tamoxifen side effects, I just think about when I was early in my career and we used to talk at some support groups, and I would talk about tamoxifen having no side effects, because we really thought it had no side effects at that time. But we have learned since then that there are side effects because of its effect on other tissues. So one of the things that we have learned is that increased risk of endometrial cancer, and that is something really important for women to be aware of.” TS 10:10

“It’s important to monitor bone mineral density, prior to the initiation of therapy and then usually yearly afterward. And then again, stress some of those lifestyle management strategies: avoiding smoking, to avoid chronic alcohol use, vitamin D and calcium, regular weight-bearing exercises, as well as looking at things such as bisphosphonate therapy or denosumab for prevention of treatment-induced bone loss.” TS 14:13

“I think there is this concept that hormone receptor–positive breast cancer is one disease. It is not. … Not only are there disease-specific aspects that we need to look at, there are patient-specific aspects that we need to look at: whether a patient is premenopausal or postmenopausal or male. Those are things that we need to consider. So I think the big misconception is that all of these drugs work the same way because all breast cancer is the same.” TS 26:39