Do you continue endocrine therapy for women with HER2+/HR+ metastatic breast cancer when starting a HER2-directed antibody-drug-conjugate?

In general, no, I would not. I do think there is room for case-by-case evaluation in determining the right course of action for a particular patient, e.g., based on how strongly the patient's tumor seems driven by ER vs HER2, how they have historically responded to ER-directed vs HER2-directed thera...