How would you approach bone-only metastases in a postmenopausal woman with HR+/HER2+ breast cancer currently on anti-HER2+/AI maintenance?

If you are convinced that her metastatic disease has progressed on her prior treatment, would consider a couple of options, including T-DM1, presumably with discontinuation of endocrine therapy (am not aware of any studies looking at T-DM1 +/- endocrine therapy in ER+/HER2+ patients). Another option...