For triple positive metastatic breast cancer, is there a role for aromatase inhibitor + CDK 4/6 inhibitor with Her2 directed therapy in a patient that refuses chemotherapy?

Recommend the PATINA trial, a randomized Phase 3 study. open to women or men with HR+, HER2+ metastatic breast cancer following completion of induction with anti-HER2-based chemotherapy. Would not recommend this approach outside of a clinical trial at this time, however.

I personally would not do it outside a clinical trial. I, on the other hand, would consider upgrading her endocrine treatment to fulvestrant.