Camizestrant Cardiac and Ocular Safety in Practice

Rebecca Shatsky, MD, reviews the safety profile of camizestrant based on her experience in the CAMBRIA adjuvant trials, highlighting photopsia, brief flashes of light in peripheral vision with no associated eye damage, and bradycardia, which she calls the Apple Watch effect after patients notice low heart rates on wearable devices overnight. She notes the FDA Oncologic Drugs Advisory Committee flagged bradycardia as a concern, though there is no evidence of cardiac damage. Camizestrant and giredestrant show more photopsia than elacestrant or imlunestrant. Dr. Shatsky adds that oral selective estrogen receptor degraders cause musculoskeletal pain similar to aromatase inhibitors, along with hot flashes and vaginal dryness, and suggests more granular patient-reported outcome tools could better capture hand swelling and stiffness current instruments may be missing.