Structural evolution progress of orally bioavailable selective estrogen receptor degraders

The alpha subtype of the estrogen receptor (ERα) plays a crucial role in breast cancer as a target for endocrine therapy. Fulvestrant, developed by AstraZeneca as the first selective estrogen receptor degraders (SERDs), effectively downregulates ER levels by reducing its stability, which leads to degradation through protein degradation mechanisms. However, the administration of Fulvestrant via the intramuscular route has imposed significant limitations on its clinical application, prompting the exploration of active oral bioavailable SERDs. Furthermore, research institutes and pharmaceutical companies have evaluated the efficacy of various oral SERDs in terms of their ability to degrade the ER, binding capacity, safety profiles, and numerous other indicators. This paper reviews recent advancements in oral SERDs, discusses their evolutionary relationships, and outlines the processes of structural modification, providing valuable insights for future research and applications.