How are you approaching endocrine therapy for patients with metastatic HR+/HER2+ breast cancer in light of enhanced HER2 directed treatment with either T-DXd/pertuzumab or HP/tucatinib?  

This is an area without clear data. I am not entirely sure that it matters. While the S8814 trial demonstrated that sequential chemotherapy followed by endocrine therapy (tamoxifen) was the best arm, this question has not been fully addressed with aromatase inhibitors. I typically would start ET wit...