UAE Becomes First Country Worldwide to Approve AstraZeneca's Oral SERD Camizestrant for ESR1-Mutant Breast Cancer
Key Insights
The UAE's Emirates Drug Establishment (search) has granted world-first approval to Etcamah (search) (camizestrant), an oral selective estrogen receptor degrader for advanced breast cancer (search) patients with ESR1 (search) mutations.
The approval was based on the Phase III SERENA-6 trial, which showed camizestrant extended progression-free survival to 16 months versus 9 months in the comparator arm.
Camizestrant reduced the risk of death by 56% during trials and is designed to delay the need for chemotherapy by preventing tumor growth in hormone-resistant cases.
The United Arab Emirates has become the first country in the world to approve Etcamah (search) (camizestrant), AstraZeneca's next-generation oral selective estrogen receptor degrader (ngSERD), for patients with advanced or metastatic breast cancer (search) harboring ESR1 (search) gene mutations. The Emirates Drug Establishment (search) (EDE) granted the approval following a comprehensive scientific and regulatory assessment, marking a significant milestone in the treatment of hormone-resistant breast cancer.
The approval positions the UAE ahead of other major regulatory bodies. While a European Medicines Agency committee recommended approval for camizestrant in the European Union last month, and the Saudi Food and Drug Authority also approved the drug, a committee of the US Food and Drug Administration voted against approving the drug at the end of April, citing reservations about trial design and the measurement of progression-free survival endpoints.
Mechanism of Action and Target Population
Etcamah (search) is indicated for patients with advanced or metastatic breast cancer (search) who have developed an ESR1 (search) gene mutation while receiving endocrine therapy. This genetic alteration can render hormone therapy less effective by enabling continued estrogen receptor signaling that drives cancer growth and spread.
Camizestrant, the active ingredient, functions as a full estrogen receptor antagonist. It works by both blocking and degrading estrogen receptors in breast cancer (search) cells, effectively cutting off the proliferative signal that fuels tumor progression. The drug is taken orally and is intended for use in combination with a CDK4/6 inhibitor, a class of agents already widely employed in breast cancer treatment.
Clinical Evidence from SERENA-6
The EDE's decision was based on findings from the Phase III SERENA-6 trial, which demonstrated statistically and clinically significant improvements in progression-free survival among patients who developed ESR1 (search) mutations while on endocrine therapy.
According to trial data, the median time to cancer worsening was significantly longer for patients receiving Etcamah (search) — 16 months — compared to 9 months for those who did not receive the drug. This 7-month improvement in progression-free survival is clinically meaningful, as delaying disease progression can substantially reduce the need for subsequent treatments, including chemotherapy with its associated toxicities.
AstraZeneca also reported that camizestrant reduced the risk of death by 56% during the trials. Patient-reported outcomes indicated that the drug improves quality of life and slows the worsening of symptoms.
The SERENA-6 trial was co-led by scientists at the Institut Curie in Paris, the Institute of Cancer Research in London, and The Royal Marsden NHS Foundation Trust in the UK, with results presented at a conference in Chicago approximately one year ago.
Regulatory and Clinical Significance
Dr. Fatima Al Kaabi, Director-General of the Emirates Drug Establishment (search), stated that the approval "reflects the efficiency of the UAE's regulatory and operational framework in evaluating and adopting pharmaceutical innovations through rigorous scientific standards." She added: "This milestone will further strengthen the UAE's commitment to building a flexible pharmaceutical ecosystem capable of anticipating global scientific developments and keeping pace with the rapid evolution of the pharmaceutical sector."
Dr. Pranay Taori, a medical oncology specialist at Aster Hospital Al Qusais in Dubai, commented: "It will improve survival in patients with hormone-positive breast cancer (search) who have failed first-line hormonal therapy and have ESR1 (search) mutations. It is encouraging to see oncology research reaching this level."
Sameh El Fangary, Gulf Country President at AstraZeneca, noted that making this treatment available in the UAE "is yet another important step towards expanding treatment options for breast cancer (search) and reflects confidence in the scientific evidence underpinning the medicine."
Breast Cancer (search) Burden and Unmet Need
Breast cancer (search) remains the most common cancer among women worldwide and the leading cause of premature death. According to the Global Burden of Disease Study Breast Cancer Collaborators published in The Lancet Oncology, annual new cases are expected to rise from 2.3 million in 2023 to more than 3.5 million by 2050, with the death toll projected to increase from 764,000 to nearly 1.4 million over the same period. A study released this year suggested that breast cancer cases globally are predicted to rise by about 50% in a generation, with Middle East countries expected to be among the most affected.
The approval of camizestrant addresses a critical unmet need for patients whose tumors acquire ESR1 (search) mutations during endocrine therapy, a scenario that compromises treatment efficacy and necessitates alternative therapeutic strategies.