New drug elinzanetant shows promise in reducing hot flashes for breast cancer survivors

A new drug, elinzanetant, has shown promise in reducing hot flashes and improving sleep for women undergoing estrogen-suppression therapy after estrogen-positive breast cancer, according to early trial results. The medication targets a symptom cluster that profoundly affects quality of life for many survivors: hot flashes, disrupted sleep and mood changes. Researchers say the results could offer a non-hormonal alternative to hormone replacement therapy, which is not used in this patient group. About 90 percent of women receiving estrogen-suppressing therapy after developing estrogen-positive breast cancer report hot flashes, making a safe, effective non-hormonal option a long-sought goal for clinicians.

In the early trial, elinzanetant significantly reduced hot flashes and improved sleep among participants. The research team stressed that while the findings are encouraging, they come from a controlled setting and must be replicated in larger, diverse populations before any regulatory approval. If confirmed, the drug would be positioned to complement existing non-drug approaches already used to manage menopausal symptoms in cancer survivors, such as cognitive behavioral therapy, acupuncture, antidepressants and anticonvulsants. These current options have shown mixed results in some studies, underscoring the potential value of a new, effective pharmacological option.

Image: Elinzanetant trial concept

The potential arrival of elinzanetant would not only address hot flashes but could also help with sleep quality, another critical factor in a survivor’s daily functioning. For clinicians, a non-hormonal therapeutic that can be used alongside behavioral and lifestyle interventions would provide a broader toolkit for managing symptoms without raising concerns about estrogen exposure in patients with breast cancer history. Researchers emphasized that the drug’s safety profile will be a central focus in forthcoming trials, particularly given the vulnerability of the population.

Beyond the primary health topic, the notes from related health columns touched on common cardiovascular and metabolic concerns faced by adults.

In one strand, readers inquired about cholesterol management and statin use. Dr. Martin Scurr noted that a cholesterol ratio, such as total cholesterol to high-density lipoprotein (HDL), is one of several indicators used to gauge heart disease risk. A ratio around 4:1 suggests that total cholesterol is four times the HDL level, but the overall risk assessment must also consider LDL and very low-density lipoprotein (VLDL) levels, as well as other factors like family history, high blood pressure, smoking and diabetes. He pointed out that a ratio above a threshold is not an automatic reason to prescribe a statin; rather, the decision should hinge on a comprehensive risk assessment. He also cited findings from large trials, such as the Jupiter Trial, which followed about 18,000 participants and found statin side effects to be no more common than in a placebo group. He added that lifestyle measures—weight management, regular exercise and smoking cessation—remain foundational to cholesterol normalization and cardiovascular risk reduction.

Another reader asked how to address elevated blood sugar and the risk of developing type 2 diabetes. Dr. Scurr explained that HbA1c provides an average blood glucose level over several weeks and is a more reliable gauge than a single reading. An HbA1c below 42 mmol/mol is normal, with 42–48 mmol/mol representing the diabetes threshold. In one case, a patient with a reading hovering around 46–47 mmol/mol was described as on the edge of diabetes. Experts emphasize that for many people, weight management remains a key strategy despite being slim or active. They highlight the importance of dietary patterns, including limiting hidden carbohydrates from beverages and processed foods, while increasing fiber-rich foods such as leafy greens and nuts. A detailed food diary and consultation with a dietitian are recommended, particularly for those whose blood sugar persists above the threshold even with an otherwise healthy lifestyle. Even with near-perfect adherence to lifestyle changes, aging and metabolic shifts can push some individuals toward medication eventually, but clinicians advise delaying pharmacotherapy where possible.

Overall, the health community remains cautiously optimistic about elinzanetant. The early trial results suggest the potential to alleviate a dominant symptom burden for breast cancer survivors on estrogen-suppressing therapy and to improve sleep—a finding that could translate into meaningful gains in daily functioning and quality of life. However, researchers stress that broader trials are needed to confirm safety and efficacy across diverse patient groups before the drug reaches the market. In the meantime, the combination of non-pharmacological therapies, careful clinical monitoring, and individualized risk assessment will continue to guide care for survivors facing hot flashes and sleep disturbances.