Baseline ESR1 mutations and fulvestrant efficacy. A, % Incidence of mutations in indicated genes at baseline in Cohort A (n = 79 assessable patients). B, Incidence of baseline ESR1 alterations within Cohort A (n = 79 assessable patients). C, PFS of patients in Cohort A, divided by baseline ESR1 Y537C mutation status (left) and ESR1 Y537S mutation status (right). P values from the log-rank test. HR >1 denotes worse PFS for that group. WT, wild-type; mt, mutant. D, MCF7 cells were cotransfected with the indicated ESR1 expression constructs and treated with the indicated concentration of fulvestrant in the presence of 1 nmol/L estradiol for 24 hours and estrogen response element-luciferase reporter activity determined. Two independent experiments.