Breast cancer is one of the most common types of cancer in women in the U.S. There are many treatments available for breast cancer. The type of treatment depends on the type of breast cancer you have.
Some breast cancers grow and spread in the presence of the hormone estrogen. This is known as estrogen-receptor-positive (ER-positive) cancer. In about 20% of breast cancers, cancer cells may also produce high amounts of a protein called human epidermal growth factor receptor 2 (HER2). HER2-positive breast cancers tend to spread more quickly than HER2-negative breast cancers.
Even with ER-positive cancer, not all cases are the same. Some people also have a specific gene mutation known as the estrogen receptor-1 (ESR1) mutation. This mutation can make certain treatments, such as some types of hormone therapy, not work as well.
In ER-positive breast cancer, hormone therapy is often used after surgery to lower the chance of cancer coming back. Sometimes, hormone therapy is started before surgery. Many types of hormone therapy are available to treat breast cancer.
One newer medicine works differently compared to others. Instead of blocking estrogen’s effects, it destroys the estrogen receptor itself. In May 2026, the FDA approved Veppanu (vepdegestrant) to treat certain people with ER-positive, HER2-negative breast cancer that is advanced or has spread (metastatic) and has an ESR1 mutation.
Continue reading to learn more about Veppanu for breast cancer.
You may also want to read about Veppanu side effects and Veppanu interactions.
How Does Veppanu Work for Breast Cancer?
In ER-positive breast cancer, estrogen signals breast cancer to grow when it attaches to estrogen receptors. Veppanu helps destroy these receptors.
Veppanu is a type of treatment called a heterobifunctional protein degrader, also known as a proteolysis-targeting chimera (PROTAC). It works by connecting to the estrogen receptor on one end and one of the body’s own protein-disposal proteins, cereblon, on the other end. This brings the two together and creates a signal that tags the estrogen receptor to be destroyed. Because the estrogen receptor is completely gone rather than just blocked, Veppanu reduces signals from estrogen receptors to the cancer, limiting growth of the cancer.
Is Veppanu Right for Me?
Veppanu may be a good option for your breast cancer if the following apply to you.
- Your breast cancer is ER-positive and HER2-negative.
- You have an ESR1 mutation, confirmed by a special test.
- Your cancer is advanced or metastatic (has spread to other body sites).
- Your cancer has gotten worse even with hormone therapy treatment.
Before starting Veppanu, make sure to tell your health care provider about all of your health conditions and any medicines you take. Veppanu has the potential to cause a rare and dangerous heart rhythm called QT prolongation. You may be at higher risk for this if any of the following apply to you.
- Long QTc syndrome
- Congestive heart failure
- Electrolyte abnormalities, such as low potassium or magnesium levels
- Use of other medicines that can prolong the QT interval
Be sure to keep all appointments, including those for heart monitoring or lab tests while you are taking the medicine. Your health care provider will use these tests to monitor you more closely to catch any heart rhythm changes early. This way, they can stop the medicine or make any needed dose changes as soon as possible. Do not stop taking Veppanu or change your dose without talking to your health care provider.
Every patient’s situation is different. Your health care provider is the best person to help decide if Veppanu is right for you.
How Was Veppanu Studied for Breast Cancer?
One clinical trial (VERITAC-2) was done to see how well Veppanu worked to treat certain people with ER-positive, HER2-negative, advanced or metastatic breast cancer. The study enrolled over 600 people, 270 of whom had an ESR1 mutation. Veppanu was studied in those 270 people.
The Eastern Cooperative Oncology Group (ECOG) Performance Status Scale is a standardized scale used in cancer studies to measure how much a person’s disease affects their daily living. The scale runs from 0 to 5. The score on ECOG Performance Status Scale before starting the study was 0 for 57% of participants and 1 for 43% of participants. Below is a summary of what ECOG Performance Status Scale scores mean.
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Below is a summary of the other characteristics of the 270 participants at the beginning of the study:
- Age: ~60 years old (ranging from 26 to 87 years)
- Sex: 269 females, one male
- Menopausal status: 20% of the 269 women were pre/perimenopausal
- Race: White (47%), Asian (41%), Black (3.3%), unknown or not reported (8%)
- Ethnicity: Not Hispanic or Latino (83%), Hispanic or Latino (7%), not reported (10%)
- 68% of participants had breast cancer that had spread to other parts of the body.
- Number of previous hormone therapies participants received: One (81%), two (19%)
- All participants had prior treatment with a CDK4/6 inhibitor, which is a common type of medicine for ER-positive and HER2-negative breast cancer.
Participants were randomly assigned to use either fulvestrant or Veppanu. Fulvestrant is another medicine used to treat this type of cancer. The study was not blinded, meaning all researchers and participants knew who was using each treatment.
The main goal of the study was to look at progression-free survival (PFS) in people with ER-positive, HER2-negative, ESR1-mutated breast cancer that had advanced or spread to other parts of the body. PFS refers to the length of time during treatment that the cancer did not grow or spread.
What Benefits Were Seen?
Among participants whose breast cancer had an ESR1 mutation, those who took Veppanu had a longer PFS of about five months, compared to about 2.1 months for those who used fulvestrant. This means that, on average, Veppanu kept the cancer from progressing nearly three months longer than fulvestrant in this group.
Keep in mind that your results may differ from what was seen in this study.
How Should I Take Veppanu?
You should take Veppanu once a day with food, exactly as your health care provider prescribes. Food helps your body absorb the medicine so it can work the way it should. You should also swallow the tablets whole. Do not chew, crush, split, or dissolve them, and do not take any tablets that are broken or damaged.
Do not change your dose or stop taking Veppanu without talking to your health care provider first. If you miss a dose or throw up after taking it, skip the missed or thrown up dose, and just take your next dose at the regular time the next day. Do not take two doses in one day to make up for a missed one.
How Do I Know if Veppanu Is Working?
You may not see changes right away. It can take weeks to months before your health care provider can tell if Veppanu is working for you. Your health care provider will look at your blood tests, scans, and symptoms to know if your breast cancer is progressing.
