How would you treat a patient with HR+,HER2- metastatic breast cancer with a gBRCA mutation who has progressed on endocrine therapy with a new pericardial effusion?

Assuming it is malignant pericardial effusion, and she has had "local therapies" such as pericardial window, if clinically indicated to prevent tamponade, then there two FDA-approved PARP inhibitors, talazoparib (Litton NEJM 2018) and olaparib (Robson NEJM 2017) for this setting. Both trials were of...

There is some retrospective data showing slightly worst outcomes in gBRCAm patients.

Combinations trial for PARPi + CDK4/6i + ET