How would you treat a newly metastatic ER+ PR+ HER2+ triple positive breast cancer with diffuse symptomatic disease and severe neuropathy from prior adjuvant paclitaxel?

This is a challenging clinical situation where the medical oncologist has to balance the need to rapidly induce a response to relieve the patient's symptoms and the risk of exacerbating the patient's peripheral neuropathy, which may be irreversible. Because of the latter concern, I would avoid stand...