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Imlunestrant

Phase 3

Breast Neoplasms | Small molecule | Oncology |Eli Lilly and Company|Last Updated: May 22, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedACTIVE_CONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment9,474
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT05514054A Study of Imlunestrant Versus Standard Endocrine Therapy in Participants With Early Breast CancerPHASE3 ACTIVE NOT_RECRUITING 8,000Oct 4, 2022Mar 1, 2032Apr 2, 2026672 United States, Argentina +29
NCT04975308A Study of Imlunestrant, Investigator's Choice of Endocrine Therapy, and Imlunestrant Plus Abemaciclib in Participants With ER+, HER2- Advanced Breast CancerPHASE3 ACTIVE NOT_RECRUITING 874Oct 4, 2021Aug 1, 2027Jul 11, 2025243 United States, Argentina +20
NCT07287098A Study of Imlunestrant (LY3484356) in Premenopausal Women With Estrogen Receptor-Positive (ER+) Human Epidermal Growth Factor Receptor 2 Negative (HER2-) Early Breast CancerPHASE2 NOT YET_RECRUITING 600May 1, 2026Dec 1, 2029May 22, 202660 United States, Belgium +5
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Study Endpoints
Primary Endpoints
Invasive Disease-Free Survival (IDFS)
Randomization to recurrence or death from any cause (up to 10 years)

IDFS excluding second non-breast primary invasive cancers

Investigator-assessed Progression Free Survival (PFS) (Between Arm A and Arm B)
Randomization to the date of first documented progression of disease or death from any cause (up to 28 months)

PFS was defined as the time from randomization to the date of first documented progression of disease or death from any cause in the absence of disease progression using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria, as assessed by investigator. Progressive disease (PD) was defined as at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions. Participants known to be alive and without disease progression were censored at the date of their last adequate tumor assessment per RECIST 1.1 criteria, or date of randomization (whichever is later).

Investigator-assessed PFS (Between Arm C and Arm A)
Randomization to the date of first documented progression of disease or death from any cause (up to 26 months)

PFS was defined as the time from randomization to the date of first documented progression of disease or death from any cause in the absence of disease progression using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria, as assessed by investigator. Progressive disease (PD) was defined as at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions. Participants known to be alive and without disease progression were censored at the date of their last adequate tumor assessment per RECIST 1.1 criteria, or date of randomization (whichever is later).

Investigator-assessed PFS in the Estrogen Receptor 1 (ESR1)-Mutation Detected Population (Between Arm A and Arm B)
Randomization to the date of first documented progression of disease or death from any cause (up to 28 months)

PFS was defined as the time from randomization to the date of first documented progression of disease or death from any cause in the absence of disease progression using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria, as assessed by investigator. Progressive disease (PD) was defined as at least a 20% increase in the sum of the diameters of target lesions, with reference being the smallest sum on study and an absolute increase of at least 5 mm, or unequivocal progression of non-target lesions, or 1 or more new lesions. Participants known to be alive and without disease progression were censored at the date of their last adequate tumor assessment per RECIST 1.1 criteria, or date of randomization (whichever is later).

Change from Baseline in Antigen Kiel (Ki-67) Expression
Baseline, Day 29
Rate of Symptomatic Ovarian Cysts
Up to Day 180
Secondary Endpoints
Distant Recurrence-Free Survival (DRFS)
Randomization to Distant Recurrence or Death from Any Cause (up to 10 Years)
Overall Survival (OS)
Randomization to Death from Any Cause (up to 10 Years)
Pharmacokinetics (PK): Steady State Plasma Concentrations of Imlunestrant
Year 1, Month 2 to Month 4
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
ImlunestrantEXPERIMENTALImlunestrant administered orally.
Investigator's Choice of Endocrine TherapyACTIVE_COMPARATORInvestigator's choice of tamoxifen, anastrozole, letrozole, or exemestane administered per local approved label.
Arm A: ImlunestrantEXPERIMENTALParticipants received Imlunestrant 400 milligrams (mg) orally once daily on days 1 to 28 of a 28-day cycle, until disease progression or a criterion for discontinuation were met.
Arm B: Investigator's Choice of Endocrine TherapyEXPERIMENTALParticipants received the investigator's choice of endocrine therapy, either exemestane 25 mg administered orally once daily on days 1 to 28 of a 28-day cycle, or Fulvestrant 500 mg intramuscularly on days 1 and 15 of Cycle 1, then on Day 1 of Cycle 2 and beyond, until disease progression or a criterion for discontinuation was met.
Arm C: Imlunestrant + AbemaciclibEXPERIMENTALParticipants received Imlunestrant 400 mg orally once daily on Days 1 to 28 of a 28-day cycle, plus Abemaciclib 150 mg orally twice daily on Days 1 to 28 of a 28-day cycle, until disease progression or a criterion for discontinuation was met.
Cohort 1 Arm AEXPERIMENTALImlunestrant will be given orally
Cohort 1 Arm B - Imlunestrant + GoserelinEXPERIMENTALImlunestrant will be given orally and goserelin will be given subcutaneously (SC)
Cohort 1 Arm C - TamoxifenACTIVE_COMPARATORTamoxifen will be given orally
Cohort 2 Arm A - ImlunestrantEXPERIMENTALImlunestrant will be given orally
Cohort 2 Arm B - TamoxifenACTIVE_COMPARATORTamoxifen will be given orally
Interventions
NameTypeDescription
ImlunestrantDRUGAdministered orally.
TamoxifenDRUGAdministered per local approved label.
AnastrozoleDRUGAdministered per local approved label.
LetrozoleDRUGAdministered per local approved label.
ExemestaneDRUGAdministered per local approved label.
FulvestrantDRUGAdministered IM.
AbemaciclibDRUGAdministered orally.
GoserelinDRUGGiven SC
Tamoxifen 20 mgDRUGGiven orally
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites672

Inclusion Criteria: * Have a diagnosis of ER+, HER2- early-stage, resected, invasive breast cancer without evidence of distant metastasis. * Participants must have received at least 24 months but not more than 60 months of any adjuvant ET, from time of adjuvant ET initiation. * Participants may hav...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilCanadaChinaCzechiaFranceGermanyGreeceHong KongHungaryIndiaIrelandIsraelItalyJapanMexicoNetherlandsPolandPortugalRomaniaSingaporeSlovakiaSouth KoreaSpainTaiwanTurkey (Türkiye)United KingdomRussiaUkraine
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Recent Changes (Last 90 Days)
LOWMay 26, 2026NCT07287098primaryCompletionDate: changed
LOWMay 26, 2026NCT04975308primaryCompletionDate: changed
LOWMay 26, 2026NCT05514054primaryCompletionDate: changed
LOWMay 24, 2026NCT07287098studyFirstPostDate: changed
LOWMay 24, 2026NCT04975308studyFirstPostDate: changed
LOWMay 24, 2026NCT05514054studyFirstPostDate: changed