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PROfound Olaparib Prostate — SCE Medical Oncology MCQ

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HardUrological CancersPROfound Olaparib ProstateSCE Medical Oncology

A patient with ESR1-mutated ER-positive, HER2-negative metastatic breast cancer is benefiting from elacestrant 345 mg once daily. Invasive fungal infection makes a course of posaconazole unavoidable. Which dosing plan best follows the current UK SmPC?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Reduce elacestrant to 86 mg once daily, restoring 345 mg after five posaconazole half-lives following discontinuation

Explanation lettering: B = shown as A · D = shown as B · E = shown as C · A = shown as D · C = shown as E

B is correct: posaconazole is a strong CYP3A4 inhibitor; if it cannot be avoided, the elacestrant dose is reduced to 86 mg once daily with careful tolerability monitoring, and the previous dose is restored only after 5 inhibitor half-lives following discontinuation. A continues full-dose exposure despite strong metabolic inhibition. C is the dose used with an unavoidable moderate CYP3A4 inhibitor and restores too early. D is the Child-Pugh B dose rather than the strong-inhibitor dose and adds an unsupported cycle delay. E unnecessarily interrupts active therapy when the SmPC supplies a dose-adjustment pathway.

Reference: Korserdu UK summary of product characteristics (Current UK SmPC, accessed 1 August 2026): https://www.medicines.org.uk/emc/product/15395/smpc