How do you approach first line therapy for metastatic, hormone receptor positive, HER2 negative breast cancer in post menopausal women?

I use palbociclib and letrozle in the vast majority of women who come to me with de novo ER positive MBC. If a woman recurs with ER positive MBC while on an AI, I use faslodex and palbociclib. Ribociclib also has shown benefit in the recently completed phase III (MONALESSA2) trial, but it is not yet...