How do you sequence therapy in metastatic ER+ HER2 low with everolimus/endocrine therapy versus fam-trastuzumab deruxtecan after progression on CDK4/6 inhibitor?  

Since the DESTINY-Breast04 trial required patients to be endocrine therapy resistant and have received 1-2 prior lines of systemic chemotherapy for metastatic disease, I would consider Enhertu only after patients progressed on everolimus and endocrine therapy.